Risk factors for default from tuberculosis treatment in HIV-infected individuals in the state of Pernambuco, Brazil: a prospective cohort study
Identifieur interne : 002102 ( Pmc/Checkpoint ); précédent : 002101; suivant : 002103Risk 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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PMC:3297544Le document en format XML
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<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>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Infect Dis</journal-id>
<journal-title-group><journal-title>BMC Infectious Diseases</journal-title>
</journal-title-group>
<issn pub-type="epub">1471-2334</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">22176628</article-id>
<article-id pub-id-type="pmc">3297544</article-id>
<article-id pub-id-type="publisher-id">1471-2334-11-351</article-id>
<article-id pub-id-type="doi">10.1186/1471-2334-11-351</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Risk factors for default from tuberculosis treatment in HIV-infected individuals in the state of Pernambuco, Brazil: a prospective cohort study</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes" id="A1"><name><surname>Maruza</surname>
<given-names>Magda</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>magdamaruza@yahoo.com.br</email>
</contrib>
<contrib contrib-type="author" id="A2"><name><surname>Militão Albuquerque</surname>
<given-names>Maria FP</given-names>
</name>
<xref ref-type="aff" rid="I2">2</xref>
<email>militao@pq.cnpq.br</email>
</contrib>
<contrib contrib-type="author" id="A3"><name><surname>Coimbra</surname>
<given-names>Isabella</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>isabella.coimbra@uol.com.br</email>
</contrib>
<contrib contrib-type="author" id="A4"><name><surname>Moura</surname>
<given-names>Líbia V</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>Mouralibia@oi.com.br</email>
</contrib>
<contrib contrib-type="author" id="A5"><name><surname>Montarroyos</surname>
<given-names>Ulisses R</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>ulisses_montarroyos@yahoo.com.br</email>
</contrib>
<contrib contrib-type="author" id="A6"><name><surname>Miranda Filho</surname>
<given-names>Demócrito B</given-names>
</name>
<xref ref-type="aff" rid="I3">3</xref>
<email>demofilho@uol.com.br</email>
</contrib>
<contrib contrib-type="author" id="A7"><name><surname>Lacerda</surname>
<given-names>Heloísa R</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<email>helramos@terra.com.br</email>
</contrib>
<contrib contrib-type="author" id="A8"><name><surname>Rodrigues</surname>
<given-names>Laura C</given-names>
</name>
<xref ref-type="aff" rid="I4">4</xref>
<email>laura.rodrigues@lshtm.ac.uk</email>
</contrib>
<contrib contrib-type="author" id="A9"><name><surname>Ximenes</surname>
<given-names>Ricardo AA</given-names>
</name>
<xref ref-type="aff" rid="I1">1</xref>
<xref ref-type="aff" rid="I3">3</xref>
<email>ricardo.ximenes@pq.cnpq.br</email>
</contrib>
</contrib-group>
<aff id="I1"><label>1</label>
Department of Tropical Medicine, Universidade Federal de Pernambuco, Recife, Brazil</aff>
<aff id="I2"><label>2</label>
NESC Department, Centro de Pesquisas Aggeu Magalhães/FIOCRUZ, Recife, Brazil</aff>
<aff id="I3"><label>3</label>
Department of Medical Science, Universidade de Pernambuco, Recife, Brazil</aff>
<aff id="I4"><label>4</label>
London School of Hygiene and Tropical Medicine, London, UK</aff>
<pub-date pub-type="collection"><year>2011</year>
</pub-date>
<pub-date pub-type="epub"><day>16</day>
<month>12</month>
<year>2011</year>
</pub-date>
<volume>11</volume>
<fpage>351</fpage>
<lpage>351</lpage>
<history><date date-type="received"><day>13</day>
<month>12</month>
<year>2010</year>
</date>
<date date-type="accepted"><day>16</day>
<month>12</month>
<year>2011</year>
</date>
</history>
<permissions><copyright-statement>Copyright ©2011 Maruza et al; licensee BioMed Central Ltd.</copyright-statement>
<copyright-year>2011</copyright-year>
<copyright-holder>Maruza et al; licensee BioMed Central Ltd.</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/2.0"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<self-uri xlink:href="http://www.biomedcentral.com/1471-2334/11/351"></self-uri>
<abstract><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>
</abstract>
</article-meta>
</front>
</pmc>
<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>
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<name sortKey="Coimbra, Isabella" sort="Coimbra, Isabella" uniqKey="Coimbra I" first="Isabella" last="Coimbra">Isabella Coimbra</name>
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<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>
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