The survival rate of tuberculosis patients in HIV-treated cohort of 2008-2018 in Almaty, Kazakhstan
| Autor: | Elina Shahumyan, Aizat Kulzhabaeva, Zhamilya Nugmanova, Alfiya Denebayeva, Marat Tukeyev, Ainur Zhandybayeva, Nune Truzyan |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Tuberculosis Population HIV Infections Comorbidity Microbiology 03 medical and health sciences 0302 clinical medicine Risk Factors Antiretroviral Therapy Highly Active Virology Internal medicine Humans Medicine 030212 general & internal medicine education Survival rate Proportional Hazards Models Retrospective Studies education.field_of_study Coinfection business.industry Proportional hazards model Retrospective cohort study General Medicine Middle Aged medicine.disease Kazakhstan Confidence interval CD4 Lymphocyte Count Survival Rate Infectious Diseases 030228 respiratory system Cohort Female Parasitology business |
| Zdroj: | The Journal of Infection in Developing Countries. 14:116S-121S |
| ISSN: | 1972-2680 |
| DOI: | 10.3855/jidc.11955 |
| Popis: | Introduction: HIV/TB comorbidity is responsible for 1.6 million deaths worldwide. HIV/TB control and patients’ survival are still among priorities of the national HIV and TB programs. We aimed to evaluate the HIV/TB survival in connection with TB treatment outcomes and factors influencing life duration of the cohort 2008-2018 in Almaty, Kazakhstan. Methodology: This retrospective cohort study extracted data for all HIV and pulmonary TB adults coinfected during 2008-2018 in Almaty from national registries to apply descriptive, Kaplan-Meier estimation, and Cox proportional hazards regression model. Survival function for the TB treatment outcomes and factors predicting the probability of survival were tested and described. Results: The cohort population (n = 521) mean age was 37.4 years with 405 (77.7%) males and 210 (40.3%) marrieds. More than one TB treatment had 181 (34.7%) patients, 291 (55.9%) were smear-positive (SS+), and 423 (81.2%) were on antiretroviral therapy with mean CD4 count 254.22cells/µL. Probability to live longer was higher (128 versus 37 months, p = 0.003; 95% confidence interval (CI) 71.65, 184.35) for those who succeeded in TB treatment compared to “lost to follow-up” and “failed” treatment outcomes. Adjusted Cox regression model death hazard showed association with missing ART treatment (HR: 1.699, 95%CI 1.164, 2.481, p = 0.006) and having CD4 count < 499 (HR 2.398, 95%CI 1.191, 4.830, p < 0.014). Conclusion: TB treatment outcomes, ART treatment, and the CD4 count of HIV/TB coinfected population substantially influence their life duration. The medical decision- and policy-makers should take this into consideration when implementing targeted improvements in the national HIV and TB programs. |
| Databáze: | OpenAIRE |
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