ArticleThe Journal of infectious diseases2013
Early immunologic failure is associated with early mortality among advanced HIV-infected adults initiating antiretroviral therapy with active tuberculosis.
Article in The Journal of infectious diseases, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome-An Extempore Game of Misfiring with Defense Arsenals.Pathogens (Basel, Switzerland) · 2023Review
- Article
- Low transcriptomic of PTPRCv1 and CD3E is an independent predictor of mortality in HIV and tuberculosis co-infected patient.Scientific reports · 2022Article
- Survival and Predictors of Mortality Among HIV Positive Adult Patients on Highly Active Antiretroviral Therapy in Public Hospitals of Kambata Tambaro Zone, Southern Ethiopia: A Retrospective Cohort Study.HIV/AIDS (Auckland, N.Z.) · 2021Article
- Insufficient tuberculosis treatment leads to earlier and higher mortality in individuals co-infected with HIV in southern China: a cohort study.BMC infectious diseases · 2020Article
- Prospective International Study of Incidence and Predictors of Immune Reconstitution Inflammatory Syndrome and Death in People Living With Human Immunodeficiency Virus and Severe Lymphopenia.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Lung Injury on Antiretroviral Therapy in Adults With Human Immunodeficiency Virus/Tuberculosis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Matrix metalloproteinases: Expression, regulation and role in the immunopathology of tuberculosis.Cell proliferation · 2019Review
- Clinical, microbiologic, and immunologic determinants of mortality in hospitalized patients with HIV-associated tuberculosis: A prospective cohort study.PLoS medicine · 2019Observational
- Factors associated with mortality in persons co-infected with tuberculosis and HIV in Suriname: a retrospective cohort study.Revista panamericana de salud publica = Pan American journal of public health · 2019Article
- Common Variation inOpen forum infectious diseases · 2018Article
- Article
- Early mortality among children and adults in antiretroviral therapy programs in Southwest Ethiopia, 2003-15.PloS one · 2018Article
- Elevated Pre-Antiretroviral Therapy CD39+CD8+ T Cell Frequency Is Associated With Early Mortality in Advanced Human Immunodeficiency Virus/Tuberculosis Co-infection.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Article
- Continued Elevation of Interleukin-18 and Interferon-γ After Initiation of Antiretroviral Therapy and Clinical Failure in a Diverse Multicountry Human Immunodeficiency Virus Cohort.Open forum infectious diseases · 2016Article
- Spectrum of Opportunistic Infections and Risk Factors for In-Hospital Mortality of Admitted AIDS Patients in Shanghai.Medicine · 2016Observational
- Robust Reconstitution of Tuberculosis-Specific Polyfunctional CD4+ T-Cell Responses and Rising Systemic Interleukin 6 in Paradoxical Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016Article
- Article
- Raised Venous Lactate and Markers of Intestinal Translocation Are Associated With Mortality Among In-Patients With HIV-Associated TB in Rural South Africa.Journal of acquired immune deficiency syndromes (1999) · 2015Observational
- The complex relationship between human immunodeficiency virus infection and death in adults being treated for tuberculosis in Cape Town, South Africa.BMC public health · 2015Article
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Authors and funding
16 authors.
Funding
Abstract
backgroundThe relationship between antiretroviral therapy (ART) response and early mortality after ART initiation is unknown. We hypothesized that early mortality is associated with decreased early immunologic response to ART.
methodsWe prospectively determined the association between changes in plasma human immunodeficiency virus type 1 (HIV-1) RNA and CD4(+) T-cell counts (CD4 count) after 4 weeks of ART and early mortality in adults with pulmonary tuberculosis and pre-ART CD4 counts ≤ 125 cells/µL. Purified protein derivative (PPD)-specific immune recovery was determined by interferon-γ enzyme-linked immunosorbent spot assays. Levels of interleukin 6, C-reactive protein, and soluble CD14 were assessed. Patients with CD4 count and viral load values at baseline and week 4 were analyzed using multiple logistic regression.
resultsEarly immunologic response, but not pre-ART CD4 counts or virologic response, was related to early mortality (8 [interquartile range {IQR}, -18 to 43] vs 68 [IQR, 24-131] cells/µL, P = .002). In a logistic regression model, every 20 cells/µL increase in the CD4 count from baseline to week 4 was independently associated with a 40% reduction in the odds of death (odds ratio, 0.59 [95% confidence interval, .41-.87]). PPD-specific immune recovery was lower, whereas levels of immune activation were higher, among deaths.
conclusionsEarly immunologic failure despite virologic suppression is associated with early mortality after ART initiation in advanced HIV/tuberculosis.
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