Incidence and Predictors of Mortality and the Effect of Tuberculosis Immune Reconstitution Inflammatory Syndrome in a Cohort of TB/HIV Patients Commencing Antiretroviral Therapy

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dc.contributor.authorWorodria, William
dc.contributor.authorMassinga-Loembe, Marguerite
dc.contributor.authorMazakpwe, Doreen
dc.contributor.authorLuzinda, Kenneth
dc.contributor.authorMayanja-Kizza, Harriet
dc.contributor.authorMugerwa, Roy D.
dc.contributor.authorReiss, Peter
dc.contributor.authorColebunders, Robert
dc.contributor.authorFor the TB-IRIS Study Group
dc.date.accessioned2022-05-25T12:11:03Z
dc.date.available2022-05-25T12:11:03Z
dc.date.issued2011
dc.description.abstractTuberculosis-HIV (TB-HIV) coinfection remains an important cause of mortality in antiretroviral therapy (ART) programs. In a cohort of TB-HIV-coinfected patients starting ART, we examined the incidence and predictors of early mortality.Consecutive TB-HIV-coinfected patients eligible for ART were enrolled in a cohort study at the Mulago National Tuberculosis and Leprosy Program clinic in Kampala, Uganda. Predictors of mortality were assessed using Cox proportional hazards analysis. Three hundred and two patients [median CD4 count 53 cells/μL (interquartile range, 20-134)] were enrolled. Fifty-three patients died, 36 (68%) of these died within the first 6 months of TB diagnosis. Male sex [hazard (HR): 2.19; 95% confidence interval (CI): 1.19 to 4.03; P = 0.011], anergy to tuberculin skin test [HR: 2.59 (1.10 to 6.12); P = 0.030], a positive serum cryptococcal antigen result at enrollment (HR: 4.27; 95% CI: 1.50 to 12.13; P = 0.006) and no ART use (HR: 4.63; 95% CI: 2. 37 to 9.03; P < 0.001) were independent predictors of mortality by multivariate analysis. Six (10%) patients with TB immune reconstitution inflammatory syndrome died, and in most, an alternative contributing cause of death was identified.Mortality among these TB-HIV-coinfected patients was high particularly when presenting with advanced HIV disease and not starting ART, reinforcing the need for timely and joint treatment for both infections. Screening for a concomitant cryptococcal infection and antifungal treatment for patients with cryptococcal antigenemia may further improve clinical outcome.en_US
dc.identifier.citationWorodria, W., Massinga-Loembe, M., Mazakpwe, D., Luzinda, K., Menten, J., Van Leth, F., ... & TB-IRIS Study Group. (2011). Incidence and predictors of mortality and the effect of tuberculosis immune reconstitution inflammatory syndrome in a cohort of TB/HIV patients commencing antiretroviral therapy. JAIDS Journal of Acquired Immune Deficiency Syndromes, 58(1), 32-37.doi: 10.1097/QAI.0b013e3182255dc2en_US
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/3331
dc.language.isoenen_US
dc.publisherJAIDS Journal of Acquired Immune Deficiency Syndromesen_US
dc.subjectHIV; immune reconstitution; mortality; predictors; tuberculosisen_US
dc.titleIncidence and Predictors of Mortality and the Effect of Tuberculosis Immune Reconstitution Inflammatory Syndrome in a Cohort of TB/HIV Patients Commencing Antiretroviral Therapyen_US
dc.typeArticleen_US
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