Short- and long-term mortality and causes of death in HIV/tuberculosis patients in Europe

Podlekareva, Daria N; Panteleev, Alexander M; Grint, Daniel; Post, Frank A; Miro, Jose M; Bruyand, Mathias; Furrer, Hansjakob; Obel, Niels; Girardi, Enrico; Vasilenko, Anna; Losso, Marcelo H; Arenas-Pinto, Alejandro; Caylá, Joan; Rakhmanova, Aza; Zeltina, Indra; Werlinrud, Anne Marie; Lundgren, Jens D; Mocroft, Amanda; Kirk, Ole; Egger, M; ... (2014). Short- and long-term mortality and causes of death in HIV/tuberculosis patients in Europe. European respiratory journal, 43(1), pp. 166-77. European Respiratory Society 10.1183/09031936.00138712

[img] Text
Podlekareva EurRespirJ 2014.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (787kB) | Request a copy

Mortality of HIV/tuberculosis (TB) patients in Eastern Europe is high. Little is known about their causes of death. This study aimed to assess and compare mortality rates and cause of death in HIV/TB patients across Eastern Europe and Western Europe and Argentina (WEA) in an international cohort study. Mortality rates and causes of death were analysed by time from TB diagnosis (<3 months, 3-12 months or >12 months) in 1078 consecutive HIV/TB patients. Factors associated with TB-related death were examined in multivariate Poisson regression analysis. 347 patients died during 2625 person-years of follow-up. Mortality in Eastern Europe was three- to ninefold higher than in WEA. TB was the main cause of death in Eastern Europe in 80%, 66% and 61% of patients who died <3 months, 3-12 months or >12 months after TB diagnosis, compared to 50%, 0% and 15% in the same time periods in WEA (p<0.0001). In multivariate analysis, follow-up in WEA (incidence rate ratio (IRR) 0.12, 95% CI 0.04-0.35), standard TB-treatment (IRR 0.45, 95% CI 0.20-0.99) and antiretroviral therapy (IRR 0.32, 95% CI 0.14-0.77) were associated with reduced risk of TB-related death. Persistently higher mortality rates were observed in HIV/TB patients in Eastern Europe, and TB was the dominant cause of death at any time during follow-up. This has important implications for HIV/TB programmes aiming to optimise the management of HIV/TB patients and limit TB-associated mortality in this region.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Furrer, Hansjakob; Egger, Matthias; Keiser, Olivia; Rauch, Andri and Schöni-Affolter, Franziska

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0903-1936

Publisher:

European Respiratory Society

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

19 Mar 2014 17:23

Last Modified:

26 Dec 2014 09:11

Publisher DOI:

10.1183/09031936.00138712

PubMed ID:

23766333

Additional Information:

HIV/TB Study Group (Members from the Uni Bern: Egger M, Furrer H, Keiser O, Rauch A, Schöni-Affolter F)

BORIS DOI:

10.7892/boris.41405

URI:

https://boris.unibe.ch/id/eprint/41405

Actions (login required)

Edit item Edit item
Provide Feedback