ArticlePloS one2012
Factors impacting early mortality in tuberculosis/HIV patients: differences between subjects naïve to and previously started on HAART.
Article in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Factors associated with severity of pulmonary tuberculosis in people living with and without HIV: a systematic review.BMC infectious diseases · 2026Pooled it
- Tuberculosis disease characteristics associated with mortality, severe morbidity and unsuccessful treatment in people living with HIV treated for tuberculosis - a secondary analysis of the ANRS 12300 Reflate TB2 trial.BMC infectious diseases · 2025Trial
- Hospitalization and diabetes mellitus as predictors of unfavorable tuberculosis treatment outcomes.BMC infectious diseases · 2026Article
- Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: associated factors and effect on mortality-a multicentre prospective cohort study.BMC infectious diseases · 2021Article
- Survival time among patients who were diagnosed with tuberculosis, the precocious deaths and associated factors in southern Brazil.Tropical medicine and health · 2021Article
- Mortality Among People With HIV Treated for Tuberculosis Based on Positive, Negative, or No Bacteriologic Test Results for Tuberculosis: The IeDEA Consortium.Open forum infectious diseases · 2020Article
- Human immunodeficiency virus-associated tuberculosis care in Botswana: evidence from a real-world setting.BMC infectious diseases · 2019Article
- Predictors of early mortality and effectiveness of antiretroviral therapy in TB-HIV patients from Brazil.PloS one · 2019Article
- Changes in tuberculosis in human immunodeficiency virus infected patients in a Spanish tertiary hospital (1995-2013).Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2018Observational
- Article
- Human Immunodeficiency Virus and Tuberculosis Coinfection in a Tertiary Hospital in Southern Brazil: Clinical Profile and Outcomes.Microbiology insights · 2018Article
- Factors associated with tuberculosis treatment delay in patients co-infected with HIV in a high prevalence area in Brazil.PloS one · 2018Article
- Article
- Mortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of death.BMC infectious diseases · 2017Observational
- Survival of people living with HIV who defaulted from tuberculosis treatment in a cohort, Recife, Brazil.BMC infectious diseases · 2017Article
- Tuberculosis Treatment Outcomes and Factors Associated with Each of Them in a Cohort Followed Up between 2010 and 2014.BioMed research international · 2017Article
- The impact of HIV status and antiretroviral treatment on TB treatment outcomes of new tuberculosis patients attending co-located TB and ART services in South Africa: a retrospective cohort study.BMC infectious diseases · 2015Article
- Delay in sputum smear conversion and outcomes of smear-positive tuberculosis patients: a retrospective cohort study in Bafoussam, Cameroon.BMC infectious diseases · 2015Article
- Determinants of death among tuberculosis patients in a semi urban diagnostic and treatment centre of Bafoussam, West Cameroon: a retrospective case-control study.The Pan African medical journal · 2015Article
- Outcome of tuberculosis treatment in HIV-positive adults diagnosed through active versus passive case-finding.Global health action · 2015Article
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Authors and funding
6 authors.
Funding
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Abstract
backgroundMortality among patients with tuberculosis (TB)/HIV is highest during the first few months of antituberculous therapy. The objective of this study was to assess the factors associated with early mortality among TB/HIV patients and whether these factors are similar for HAART naïve and those with prior HAART initiation.
methodsProspective cohort study including HIV patients with tuberculosis confirmed by culture, cared for at a referral center in Rio de Janeiro, Brazil. Multivariable Cox analysis was used to assess predictors of mortality within 3 months of antituberculous therapy.
resultsAmong 227 patients included, 90 (40%) started HAART before TB diagnosis. The median time to TB diagnosis after ARV initiation was 5.9 months (interquartile range [IQR] 3.0-8.9 months). Fourteen patients (6%) died within the first 3 months. Mortality was not different between patients previously started on HAART and those who were naïve to it. In the overall adjusted analysis, HAART use during TB treatment (hazard ratio [HR] =0.21, 95% confidential interval [CI] =0.06-0.72) and CD4 lymphocyte count >100 cells/mm3 (HR=0.21, 95% CI=0.04-0.99) were associated with lower mortality, while subjects with unknown baseline CD4 lymphocyte count (HR=9.39, 95% CI=2.56-34.5) had higher mortality. In subgroup analysis, among HAART naïve subjects, disseminated TB (HR=5.32, 95% CI=1.09-25.8) and unknown baseline CD4 lymphocyte count (HR=13.2, 95% CI=2.71-64.5) were associated with significantly higher mortality, while HAART (HR=0.14, 95% CI=0.03-0.69) predicted a better outcome. Among subjects previously started on HAART, mortality was significantly associated with duration of TB symptoms >120 days (HR=6.15, 95% CI=1.15-32.9).
conclusionsPredictors of early mortality among TB/HIV patients may vary according to the timing of HAART initiation. Among HAART naïve patients, mortality was influenced by baseline clinical severity, HAART use and, possibly, the quality of care preceding TB diagnosis. For patients with prior HAART initiation, longer delays in TB diagnosis predicted a significantly higher mortality.
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