HIV co-infection increases the risk of post-tuberculosis mortality among persons who initiated treatment for drug-resistant tuberculosis.

Autor: Salindri AD; Department of Population Health Sciences, Georgia State University School of Public Health, Atlanta, GA, USA. adsalind@stanford.edu.; Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA. adsalind@stanford.edu., Kipiani M; National Center for Tuberculosis and Lung Diseases, Tbilisi, Georgia.; David Tvildiani Medical University, Tbilisi, Georgia.; The University of Georgia, Tbilisi, Georgia., Lomtadze N; National Center for Tuberculosis and Lung Diseases, Tbilisi, Georgia.; David Tvildiani Medical University, Tbilisi, Georgia.; The University of Georgia, Tbilisi, Georgia., Tukvadze N; National Center for Tuberculosis and Lung Diseases, Tbilisi, Georgia.; Department of Medicine, Swiss Tropical and Public Health Institute, Allschwil, Switzerland., Avaliani Z; National Center for Tuberculosis and Lung Diseases, Tbilisi, Georgia.; European University, Tbilisi, Georgia., Blumberg HM; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.; Hubert Department of Global Health and Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA., Masyn KE; Department of Population Health Sciences, Georgia State University School of Public Health, Atlanta, GA, USA., Rothenberg RB; Department of Population Health Sciences, Georgia State University School of Public Health, Atlanta, GA, USA., Kempker RR; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA., Magee MJ; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA. mjmagee@emory.edu.; Hubert Department of Global Health and Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA. mjmagee@emory.edu.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Oct 11; Vol. 14 (1), pp. 23834. Date of Electronic Publication: 2024 Oct 11.
DOI: 10.1038/s41598-024-68605-2
Abstrakt: Little is known regarding the relationship between common comorbidities in persons with tuberculosis (TB) (including human immunodeficiency virus [HIV], diabetes, and hepatitis C virus [HCV]) and post-TB mortality. We conducted a retrospective cohort study among persons who initiated treatment for rifampicin-resistant or multi/extensively drug-resistant (RR or M/XDR) TB reported to the country of Georgia's TB surveillance during 2009-2017. Exposures included HIV serologic status, diabetes, and HCV status. Our outcome was all-cause post-TB mortality determined by cross-validating vital status with Georgia's death registry through November 2019. We estimated adjusted hazard rate ratios (aHR) and 95% confidence intervals (CI) of post-TB mortality among participants with and without comorbidities using cause-specific hazard regressions. Among 1032 eligible participants, 34 (3.3%) died during treatment and 87 (8.7%) died post-TB treatment. The median time to post-TB death was 21 months (interquartile range 7-39) after TB treatment. After adjusting for confounders, the hazard rates of post-TB mortality were higher among participants with HIV co-infection (aHR = 3.74, 95%CI 1.77-7.91) compared to those without HIV co-infection. In our cohort, post-TB mortality occurred most commonly in the first 3 years post-TB treatment. Linkage to care for common TB comorbidities post-treatment may reduce post-TB mortality rates.
(© 2024. The Author(s).)
Databáze: MEDLINE
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