Observational studyThe Journal of infectious diseases2017
Hemostatic Changes Associated With Increased Mortality Rates in Hospitalized Patients With HIV-Associated Tuberculosis: A Prospective Cohort Study.
Observational study in The Journal of infectious diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Mycobacterium tuberculosis bloodstream infection prevalence, diagnosis, and mortality risk in seriously ill adults with HIV: a systematic review and meta-analysis of individual patient data.The Lancet. Infectious diseases · 2020Pooled it
- Effect of BMI on Mortality in Patients With Tuberculosis and HIV Coinfection in Asia and Africa: Systematic Review and Meta-Analysis.Asian/Pacific Island nursing journal · 2026Review
- Pathogen Detection in Spinal Infections: Next-Generation Sequencing Versus Conventional Microbiological Methods.Current medical science · 2025Article
- Tuberculosis: An Update for the Clinician.Respirology (Carlton, Vic.) · 2025Review
- Exploring Health-Related Quality of Life (HRQOL) among patients with HIV-associated TB in Khayelitsha, South Africa.PloS one · 2024Article
- Xpert Ultra testing of blood in severe HIV-associated tuberculosis to detect and measure Mycobacterium tuberculosis blood stream infection: a diagnostic and disease biomarker cohort study.The Lancet. Microbe · 2022Article
- Serial measurement of M. tuberculosis in blood from critically-ill patients with HIV-associated tuberculosis.EBioMedicine · 2022Article
- Enhanced Human Immunodeficiency Virus-1 Replication in CD4+ T Cells Derived From Individuals With Latent Mycobacterium tuberculosis Infection.The Journal of infectious diseases · 2020Article
- A multi-parameter diagnostic clinical decision tree for the rapid diagnosis of tuberculosis in HIV-positive patients presenting to an emergency centre.Wellcome open research · 2020Article
- Good Fences Make Good Neighbors: Human Immunodeficiency Virus and Vascular Disease.Open forum infectious diseases · 2019Review
- Effect of Empiric Anti-Open forum infectious diseases · 2019Article
- Trends in C-Reactive Protein, D-Dimer, and Fibrinogen during Therapy for HIV-Associated Multidrug-Resistant Tuberculosis.The American journal of tropical medicine and hygiene · 2018Article
- HIV-Associated Mycobacterium tuberculosis Bloodstream Infection Is Underdiagnosed by Single Blood Culture.Journal of clinical microbiology · 2018Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundMortality rates remain high for human immunodeficiency virus (HIV)-associated tuberculosis, and our knowledge of contributing mechanisms is limited. We aimed to determine whether hemostatic changes in HIV-tuberculosis were associated with mortality or decreased survival time and the contribution of mycobacteremia to these effects.
methodsWe conducted a prospective study in Khayelitsha, South Africa, in hospitalized HIV-infected patients with CD4 cell counts <350/µL and microbiologically proved tuberculosis. HIV-infected outpatients without tuberculosis served as controls. Plasma biomarkers reflecting activation of procoagulation and anticoagulation, fibrinolysis, endothelial cell activation, matricellular protein release, and tissue damage were measured at admission. Cox proportional hazard models were used to assess variables associated with 12-week mortality rates.
resultsOf 59 patients with HIV-tuberculosis, 16 (27%) died after a median of 12 days (interquartile range, 0-24 days); 29 (64%) of the 45 not receiving anticoagulants fulfilled criteria for disseminated intravascular coagulation. Decreased survival time was associated with higher concentrations of markers of fibrinolysis, endothelial activation, matricellular protein release, and tissue damage and with decreased concentrations for markers of anticoagulation. In patients who died, coagulation factors involved in the common pathway were depleted (factor II, V, X), which corresponded to increased plasma clotting times. Mycobacteremia modestly influenced hemostatic changes without affecting mortality.
conclusionsPatients with severe HIV-tuberculosis display a hypercoagulable state and activation of the endothelium, which is associated with mortality.
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