Sobrevida de portadores da coinfecção HIV/TB em Goiás: um estudo de coorte

• Autor(a) principal: Souza, Christiane Moreira
• Data de Publicação: 2014
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFG
• Texto Completo: http://repositorio.bc.ufg.br/tede/handle/tede/4252
• topic: Coinfecção; Sobrevida; HIV; Tuberculose; Coinfection; Survival; Tuberculosis; CIENCIAS DA SAUDE::ENFERMAGEM

The HIV/TB coinfection represents a challenge for public health, since this association has impacted both the epidemiology, natural history and clinical course of both diseases. The aim of this study was to analyze the survival of individuals coinfected with HIV and with Mtb in Goiás. This is a retrospective epidemiological cohort study (2003-2011) individuals with HIV infection who developed tuberculosis during the study period. Linkage was performed between the medical records of patients followed up at a referral hospital with database SINAN- TB and SIM Goiás. The cumulative probability of survival was calculated by Kaplan-Meier. Among coinfected patients, the mean age was 35.2 years; the majority were male (74.1%); with less than eight years of education (45.6%); unmarried (67.4%); black or brown (78.5%) and in the interior of Goiás (70.7%). The incidence of coinfection HIV/TB was 7.1%. Yet, coinfected showed 61.5% of the LT- counting CD4 <350 cells/mm3; underwent 83.0 % AFB and 42.2 % PPD. The extrapulmonary forms and mixed accounted for 76.7% of cases. Scheme I was mostly used to treat TB (86.3 %) and 67.4 % of coinfected initiated the use of ART. Death occurred in 36.7% of coinfected. Univariate analysis identified that have counts of the first LT - CD4 < 350 cells/mm3 was associated with the development of TB (OR: 2.93); death was double among patients with co-infection (OR: 2.07) and that males are more affected by TB (OR: 1.79). The analysis of cumulative survival identified that 4.0% of coinfected with TB while the diagnosis of HIV; the development of TB was higher for males (p < 0.001); individuals with count values LT - CD4 + ≤ 00 ce s/ mm3 had a higher probability of having TB (p < 0.001) and did not initiate ART within 24 months after the diagnosis of tuberculosis has contributed significantly to the increase in the rate of deaths (p < 0.001). It is necessary to develop joint policies aimed at reducing the clinical and epidemiological impact of a disease on the other, making priority: early detection of HIV and TB, adherence to ART, TB research in individuals with HIV, treatment