Mortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of death

Detalhes bibliográficos
Autor(a) principal: Escada, Rodrigo Otavio da Silva
Data de Publicação: 2017
Outros Autores: Velasque, Luciane, Ribeiro, Sayonara Rocha, Cardoso, Sandra Wagner, Marins, Luana Monteiro Spindola, Grinsztejn, Eduarda, Lourenço, Maria Cristina da Silva, Grinsztejn, Beatriz, Veloso, Valdiléa G.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/27773
Resumo: Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
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spelling Escada, Rodrigo Otavio da SilvaVelasque, LucianeRibeiro, Sayonara RochaCardoso, Sandra WagnerMarins, Luana Monteiro SpindolaGrinsztejn, EduardaLourenço, Maria Cristina da SilvaGrinsztejn, BeatrizVeloso, Valdiléa G.2018-08-01T18:36:33Z2018-08-01T18:36:33Z2017ESCADA, Rodrigo Otavio da Silva et al. Mortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of death. BMC Infectious Diseases, v. 17, n. 373, p. 1-10, 2017.1471-2334https://www.arca.fiocruz.br/handle/icict/2777310.1186/s12879-017-2473-yengBioMed CentralMortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of deathinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Universidade Federal do Estado do Rio de Janeiro, Departamento de Matemática e Estatística. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Background: Tuberculosis is the most frequent opportunistic infection and the leading cause of death among persons living with HIV in several low and middle-income countries. Mortality rates during tuberculosis treatment and death causes among HIV-1/TB co-infected patients may differ based on the immunosuppression severity, timing of diagnosis and prompt initiation of tuberculosis and antiretroviral therapy. Methods: This was a retrospective observational study conducted in the clinical cohort of patients with HIV-1/Aids of the National Institute of Infectious Diseases Evandro Chagas, Rio de Janeiro, Brazil. All HIV-1 infected patients who started combination antiretroviral therapy up to 30 days before or within 180 days after the start of tuberculosis treatment from 2000 to 2010 were eligible. Causes of death were categorized according to the "Coding Causes of Death in HIV” (CoDe) protocol. The Cox model was used to estimate the hazard ratio (HR) of selected mortality variables. Results: A total of 310 patients were included. Sixty-four patients died during the study period. Mortality rate following tuberculosis treatment initiation was 44 per 100 person-years within the first 30 days, 28.1 per 100 person-years within 31 and 90 days, 6 per 100 person-years within 91 and 365 days and 1.6 per 100 person-years after 365 days. Death probability within one year from tuberculosis treatment initiation was approximately 13%. In the adjusted analysis the associated factors with mortality were: CD4 ≤ 50 cells/mm3 (HR: 3.10; 95% CI: 1.720 to 5.580; p = 0.00); mechanical ventilation (HR: 2.81; 95% CI: 1.170 to 6.760; p = 0.02); and disseminated tuberculosis (HR: 3.70; 95% CI: 1.290 to 10.590, p = 0.01). Invasive bacterial disease was the main immediate cause of death (46.9%). Conclusion: Our results evidence the high morbidity and mortality among patients co-infected with HIV-1 and tuberculosis in Rio de Janeiro, Brazil. During the first year following tuberculosis diagnosis, mortality was the highest within the first 3 months, being invasive bacterial infection the major cause of death. In order to successfully intervene in this scenario, it is utterly necessary to address the social determinants of health contributing to the inequitable health care access faced by this population.TuberculosisMortalityCoDeBacterial DiseaseHIV/AidsCohort StudyBrazilinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83099https://www.arca.fiocruz.br/bitstream/icict/27773/1/license.txt586c046dcfeef936e32f0323bb9a47c0MD51ORIGINALMortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro_Rodrigo_Escada_etal_INI_Lapclin_2017.pdfMortality in patients with HIV-1 and tuberculosis co-infection in Rio de 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dc.title.pt_BR.fl_str_mv Mortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of death
title Mortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of death
spellingShingle Mortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of death
Escada, Rodrigo Otavio da Silva
Tuberculosis
Mortality
CoDe
Bacterial Disease
HIV/Aids
Cohort Study
Brazil
title_short Mortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of death
title_full Mortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of death
title_fullStr Mortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of death
title_full_unstemmed Mortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of death
title_sort Mortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of death
author Escada, Rodrigo Otavio da Silva
author_facet Escada, Rodrigo Otavio da Silva
Velasque, Luciane
Ribeiro, Sayonara Rocha
Cardoso, Sandra Wagner
Marins, Luana Monteiro Spindola
Grinsztejn, Eduarda
Lourenço, Maria Cristina da Silva
Grinsztejn, Beatriz
Veloso, Valdiléa G.
author_role author
author2 Velasque, Luciane
Ribeiro, Sayonara Rocha
Cardoso, Sandra Wagner
Marins, Luana Monteiro Spindola
Grinsztejn, Eduarda
Lourenço, Maria Cristina da Silva
Grinsztejn, Beatriz
Veloso, Valdiléa G.
author2_role author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Escada, Rodrigo Otavio da Silva
Velasque, Luciane
Ribeiro, Sayonara Rocha
Cardoso, Sandra Wagner
Marins, Luana Monteiro Spindola
Grinsztejn, Eduarda
Lourenço, Maria Cristina da Silva
Grinsztejn, Beatriz
Veloso, Valdiléa G.
dc.subject.en.pt_BR.fl_str_mv Tuberculosis
Mortality
CoDe
Bacterial Disease
HIV/Aids
Cohort Study
Brazil
topic Tuberculosis
Mortality
CoDe
Bacterial Disease
HIV/Aids
Cohort Study
Brazil
description Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
publishDate 2017
dc.date.issued.fl_str_mv 2017
dc.date.accessioned.fl_str_mv 2018-08-01T18:36:33Z
dc.date.available.fl_str_mv 2018-08-01T18:36:33Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.citation.fl_str_mv ESCADA, Rodrigo Otavio da Silva et al. Mortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of death. BMC Infectious Diseases, v. 17, n. 373, p. 1-10, 2017.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/27773
dc.identifier.issn.pt_BR.fl_str_mv 1471-2334
dc.identifier.doi.none.fl_str_mv 10.1186/s12879-017-2473-y
identifier_str_mv ESCADA, Rodrigo Otavio da Silva et al. Mortality in patients with HIV-1 and tuberculosis co-infection in Rio de Janeiro, Brazil - associated factors and causes of death. BMC Infectious Diseases, v. 17, n. 373, p. 1-10, 2017.
1471-2334
10.1186/s12879-017-2473-y
url https://www.arca.fiocruz.br/handle/icict/27773
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dc.publisher.none.fl_str_mv BioMed Central
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