Risk factors for default from tuberculosis treatment in HIV-infected individuals in the state of Pernambuco, Brazil: a prospective cohort study
Identifieur interne : 003B82 ( Main/Exploration ); précédent : 003B81; suivant : 003B83Risk factors for default from tuberculosis treatment in HIV-infected individuals in the state of Pernambuco, Brazil: a prospective cohort study
Auteurs : Magda Maruza [Brésil] ; Maria Fp Militão Albuquerque [Brésil] ; Isabella Coimbra [Brésil] ; Líbia V. Moura [Brésil] ; Ulisses R. Montarroyos [Brésil] ; Dem Crito B. Miranda Filho [Brésil] ; Heloísa R. Lacerda [Brésil] ; Laura C. Rodrigues [Royaume-Uni] ; Ricardo Aa Ximenes [Brésil]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2011.
Abstract
Concomitant treatment of Human Immunodeficiency Virus (HIV) infection and tuberculosis (TB) presents a series of challenges for treatment compliance for both providers and patients. We carried out this study to identify risk factors for default from TB treatment in people living with HIV.
We conducted a cohort study to monitor HIV/TB co-infected subjects in Pernambuco, Brazil, on a monthly basis, until completion or default of treatment for TB. Logistic regression was used to calculate crude and adjusted odds ratios, 95% confidence intervals and
From a cohort of 2310 HIV subjects, 390 individuals (16.9%) who had started treatment after a diagnosis of TB were selected, and data on 273 individuals who completed or defaulted on treatment for TB were analyzed. The default rate was 21.7% and the following risk factors were identified: male gender, smoking and CD4 T-cell count less than 200 cells/mm3. Age over 29 years, complete or incomplete secondary or university education and the use of highly active antiretroviral therapy (HAART) were identified as protective factors for the outcome.
The results point to the need for more specific actions, aiming to reduce the default from TB treatment in males, younger adults with low education, smokers and people with CD4 T-cell counts < 200 cells/mm3. Default was less likely to occur in patients under HAART, reinforcing the strategy of early initiation of HAART in individuals with TB.
Url:
DOI: 10.1186/1471-2334-11-351
PubMed: 22176628
PubMed Central: 3297544
Affiliations:
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Moura</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Tropical Medicine, Universidade Federal de Pernambuco, Recife, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Tropical Medicine, Universidade Federal de Pernambuco, Recife</wicri:regionArea><wicri:noRegion>Recife</wicri:noRegion></affiliation></author><author><name sortKey="Montarroyos, Ulisses R" sort="Montarroyos, Ulisses R" uniqKey="Montarroyos U" first="Ulisses R" last="Montarroyos">Ulisses R. Montarroyos</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Tropical Medicine, Universidade Federal de Pernambuco, Recife, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Tropical Medicine, Universidade Federal de Pernambuco, Recife</wicri:regionArea><wicri:noRegion>Recife</wicri:noRegion></affiliation></author><author><name sortKey="Miranda Filho, Dem Crito B" sort="Miranda Filho, Dem Crito B" uniqKey="Miranda Filho D" first="Dem Crito B" last="Miranda Filho">Dem Crito B. Miranda Filho</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of Medical Science, Universidade de Pernambuco, Recife, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Medical Science, Universidade de Pernambuco, Recife</wicri:regionArea><wicri:noRegion>Recife</wicri:noRegion></affiliation></author><author><name sortKey="Lacerda, Heloisa R" sort="Lacerda, Heloisa R" uniqKey="Lacerda H" first="Heloísa R" last="Lacerda">Heloísa R. Lacerda</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Tropical Medicine, Universidade Federal de Pernambuco, Recife, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Tropical Medicine, Universidade Federal de Pernambuco, Recife</wicri:regionArea><wicri:noRegion>Recife</wicri:noRegion></affiliation></author><author><name sortKey="Rodrigues, Laura C" sort="Rodrigues, Laura C" uniqKey="Rodrigues L" first="Laura C" last="Rodrigues">Laura C. Rodrigues</name><affiliation wicri:level="3"><nlm:aff id="I4">London School of Hygiene and Tropical Medicine, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Ximenes, Ricardo Aa" sort="Ximenes, Ricardo Aa" uniqKey="Ximenes R" first="Ricardo Aa" last="Ximenes">Ricardo Aa Ximenes</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Tropical Medicine, Universidade Federal de Pernambuco, Recife, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Tropical Medicine, Universidade Federal de Pernambuco, Recife</wicri:regionArea><wicri:noRegion>Recife</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">Department of Medical Science, Universidade de Pernambuco, Recife, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Department of Medical Science, Universidade de Pernambuco, Recife</wicri:regionArea><wicri:noRegion>Recife</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Infectious Diseases</title><idno type="eISSN">1471-2334</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Concomitant treatment of Human Immunodeficiency Virus (HIV) infection and tuberculosis (TB) presents a series of challenges for treatment compliance for both providers and patients. We carried out this study to identify risk factors for default from TB treatment in people living with HIV.</p></sec><sec><title>Methods</title><p>We conducted a cohort study to monitor HIV/TB co-infected subjects in Pernambuco, Brazil, on a monthly basis, until completion or default of treatment for TB. Logistic regression was used to calculate crude and adjusted odds ratios, 95% confidence intervals and <italic>P</italic>-values.</p></sec><sec><title>Results</title><p>From a cohort of 2310 HIV subjects, 390 individuals (16.9%) who had started treatment after a diagnosis of TB were selected, and data on 273 individuals who completed or defaulted on treatment for TB were analyzed. The default rate was 21.7% and the following risk factors were identified: male gender, smoking and CD4 T-cell count less than 200 cells/mm<sup>3</sup>. Age over 29 years, complete or incomplete secondary or university education and the use of highly active antiretroviral therapy (HAART) were identified as protective factors for the outcome.</p></sec><sec><title>Conclusion</title><p>The results point to the need for more specific actions, aiming to reduce the default from TB treatment in males, younger adults with low education, smokers and people with CD4 T-cell counts < 200 cells/mm<sup>3</sup>. Default was less likely to occur in patients under HAART, reinforcing the strategy of early initiation of HAART in individuals with TB.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Mayer, Kh" uniqKey="Mayer K">KH Mayer</name></author><author><name sortKey="Hamilton, Cd" uniqKey="Hamilton C">CD Hamilton</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Sterling, Tr" uniqKey="Sterling T">TR Sterling</name></author><author><name sortKey="Pham, Pa" uniqKey="Pham P">PA Pham</name></author><author><name sortKey="Chaisson, Re" uniqKey="Chaisson R">RE Chaisson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Meintjes, G" uniqKey="Meintjes G">G Meintjes</name></author><author><name sortKey="Rabie, H" uniqKey="Rabie H">H 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sortKey="Salleh, R" uniqKey="Salleh R">R Salleh</name></author><author><name sortKey="Bakar, N" uniqKey="Bakar N">N Bakar</name></author><author><name sortKey="Mahmod, Mr" uniqKey="Mahmod M">MR Mahmod</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Salami, Ak" uniqKey="Salami A">AK Salami</name></author><author><name sortKey="Oluboyo, Po" uniqKey="Oluboyo P">PO Oluboyo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="De Vos, Pf" uniqKey="De Vos P">PF de Vos</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Matebesi, Z" uniqKey="Matebesi Z">Z Matebesi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Goncalves, H" uniqKey="Goncalves H">H Gonçalves</name></author><author><name sortKey="Costa, Jsd" uniqKey="Costa J">JSD Costa</name></author><author><name sortKey="Menezes, Amb" uniqKey="Menezes A">AMB Menezes</name></author><author><name sortKey="Knauth, D" uniqKey="Knauth D">D Knauth</name></author><author><name sortKey="Leal, Of" uniqKey="Leal O">OF Leal</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jessor, R" uniqKey="Jessor R">R Jessor</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Webb, Ms" uniqKey="Webb M">MS Webb</name></author><author><name sortKey="Vanable, Pa" uniqKey="Vanable P">PA Vanable</name></author><author><name sortKey="Carey, Mp" uniqKey="Carey M">MP Carey</name></author><author><name sortKey="Blair, Dc" uniqKey="Blair D">DC Blair</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Brésil</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><country name="Brésil"><noRegion><name sortKey="Maruza, Magda" sort="Maruza, Magda" uniqKey="Maruza M" first="Magda" last="Maruza">Magda Maruza</name></noRegion><name sortKey="Coimbra, Isabella" sort="Coimbra, Isabella" uniqKey="Coimbra I" first="Isabella" last="Coimbra">Isabella Coimbra</name><name sortKey="Lacerda, Heloisa R" sort="Lacerda, Heloisa R" uniqKey="Lacerda H" first="Heloísa R" last="Lacerda">Heloísa R. Lacerda</name><name sortKey="Militao Albuquerque, Maria Fp" sort="Militao Albuquerque, Maria Fp" uniqKey="Militao Albuquerque M" first="Maria Fp" last="Militão Albuquerque">Maria Fp Militão Albuquerque</name><name sortKey="Miranda Filho, Dem Crito B" sort="Miranda Filho, Dem Crito B" uniqKey="Miranda Filho D" first="Dem Crito B" last="Miranda Filho">Dem Crito B. Miranda Filho</name><name sortKey="Montarroyos, Ulisses R" sort="Montarroyos, Ulisses R" uniqKey="Montarroyos U" first="Ulisses R" last="Montarroyos">Ulisses R. Montarroyos</name><name sortKey="Moura, Libia V" sort="Moura, Libia V" uniqKey="Moura L" first="Líbia V" last="Moura">Líbia V. Moura</name><name sortKey="Ximenes, Ricardo Aa" sort="Ximenes, Ricardo Aa" uniqKey="Ximenes R" first="Ricardo Aa" last="Ximenes">Ricardo Aa Ximenes</name><name sortKey="Ximenes, Ricardo Aa" sort="Ximenes, Ricardo Aa" uniqKey="Ximenes R" first="Ricardo Aa" last="Ximenes">Ricardo Aa Ximenes</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Rodrigues, Laura C" sort="Rodrigues, Laura C" uniqKey="Rodrigues L" first="Laura C" last="Rodrigues">Laura C. Rodrigues</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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