Observational studyJournal of acquired immune deficiency syndromes (1999)2015
Raised Venous Lactate and Markers of Intestinal Translocation Are Associated With Mortality Among In-Patients With HIV-Associated TB in Rural South Africa.
Observational study in Journal of acquired immune deficiency syndromes (1999), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 21 citations in OpenAlex.
- Microbial product translocation and mortality in adults hospitalised with HIV-associated tuberculosis: a prospective observational cohort study.Research square · 2026Article
- Article
- Rifampicin resistance and mortality in patients hospitalised with HIV-associated tuberculosis.Southern African journal of HIV medicine · 2022Article
- Identification and validation of a T-cell-related MIR600HG/hsa-mir-21-5p competing endogenous RNA network in tuberculosis activation based on integrated bioinformatics approaches.Frontiers in genetics · 2022Article
- Population Pharmacokinetics and Significant Under-Dosing of Anti-Tuberculosis Medications in People with HIV and Critical Illness.Antibiotics (Basel, Switzerland) · 2021Article
- Tuberculosis deaths are predictable and preventable: Comprehensive assessment and clinical care is the key.Journal of clinical tuberculosis and other mycobacterial diseases · 2020Article
- Early antituberculosis drug exposure in hospitalized patients with human immunodeficiency virus-associated tuberculosis.British journal of clinical pharmacology · 2020Article
- Clinical, microbiologic, and immunologic determinants of mortality in hospitalized patients with HIV-associated tuberculosis: A prospective cohort study.PLoS medicine · 2019Observational
- Management of active tuberculosis in adults with HIV.The lancet. HIV · 2019Review
- Article
- Disseminated tuberculosis among hospitalised HIV patients in South Africa: a common condition that can be rapidly diagnosed using urine-based assays.Scientific reports · 2017Article
- Factors Associated with Mortality of TB/HIV Co-infected Patients in Ethiopia.Ethiopian journal of health sciences · 2017Article
- Hemostatic Changes Associated With Increased Mortality Rates in Hospitalized Patients With HIV-Associated Tuberculosis: A Prospective Cohort Study.The Journal of infectious diseases · 2017Observational
Corrections and comments
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Authors and funding
8 authors at 6 institutions in 3 countries.
Funding
Abstract
introductionCase fatality among in-patients with HIV-associated tuberculosis (HIV-TB) in Africa is high. We investigated the factors associated with mortality in a rural South African hospital.
methodsThis was a prospective observational study of HIV-TB in-patients, with death by 8 weeks the endpoint.
resultsOf 99 patients (median CD4 count 72 cells/mm³), 32 (32%) died after median 8-day TB treatment. TB was diagnosed microbiologically in 75/99 and clinico-radiologically in 24, with no mortality difference between these groups [31% versus 38% (P = 0.53)]. Median venous lactate was 5.5 mmol/L (interquartile range 3.9-6.2) in those who died and 3.1 mmol/L (interquartile range 2.2-4.1) in survivors (P < 0.001). In multivariable analysis, lactate ≥4 mmol/L [adjusted odds ratio (aOR) 9.8, 95% confidence interval (CI): 3.0 to 32.2], Glasgow Coma Score <15 (aOR 6.6, 95% CI: 1.5 to 29.6), CD4 count <50 cells per cubic millimeter (aOR 5.5, 95% CI: 1.6 to 18.5), and age ≥50 (aOR 7.7, 95% CI: 1.2 to 46.9) independently predicted death. In a nested case-control study, comparing those who died versus CD4-matched survivors, median plasma lipopolysaccharide concentrations were 93 and 57 pg/mL (P = 0.026) and intestinal fatty acid-binding protein, 132 and 0 pg/mL (P = 0.002).
conclusionsMortality was high and predicted by elevated lactate, likely reflecting a sepsis-syndrome secondary to TB or bacterial coinfection with intestinal barrier dysfunction appearing to contribute.
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