Site of Extrapulmonary Tuberculosis is Associated with HIV Infection
Identifieur interne : 001638 ( Ncbi/Merge ); précédent : 001637; suivant : 001639Site of Extrapulmonary Tuberculosis is Associated with HIV Infection
Auteurs : Ira L. Leeds ; Matthew J. Magee ; Ekaterina V. Kurbatova ; Carlos Del Rio ; Henry M. Blumberg ; Michael K. Leonard ; Colleen S. Kraft [États-Unis]Source :
- Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America [ 1058-4838 ] ; 2012.
Abstract
The site of extrapulmonary tuberculosis infection has a known effect on mortality. Authors use a large clinical case series to identify previously unconfirmed risk factors that are associated with site of extrapulmonary tuberculosis infection.
Url:
DOI: 10.1093/cid/cis303
PubMed: 22423123
PubMed Central: 3493181
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Leeds</name><affiliation><nlm:aff id="af1"><institution>Emory University School of Medicine</institution></nlm:aff></affiliation></author><author><name sortKey="Magee, Matthew J" sort="Magee, Matthew J" uniqKey="Magee M" first="Matthew J." last="Magee">Matthew J. Magee</name><affiliation><nlm:aff id="af2"><addr-line>Departments of Epidemiology and Global Health, Rollins School of Public Health</addr-line></nlm:aff><wicri:noCountry code="subfield">Rollins School of Public Health</wicri:noCountry></affiliation></author><author><name sortKey="Kurbatova, Ekaterina V" sort="Kurbatova, Ekaterina V" uniqKey="Kurbatova E" first="Ekaterina V." last="Kurbatova">Ekaterina V. Kurbatova</name><affiliation><nlm:aff id="af3"><addr-line>Division of Infectious Diseases, Department of Medicine</addr-line></nlm:aff><wicri:noCountry code="subfield">Department of Medicine</wicri:noCountry></affiliation></author><author><name sortKey="Del Rio, Carlos" sort="Del Rio, Carlos" uniqKey="Del Rio C" first="Carlos" last="Del Rio">Carlos Del Rio</name><affiliation><nlm:aff id="af1"><institution>Emory University School of Medicine</institution></nlm:aff></affiliation><affiliation><nlm:aff id="af2"><addr-line>Departments of Epidemiology and Global Health, Rollins School of Public Health</addr-line></nlm:aff><wicri:noCountry code="subfield">Rollins School of Public Health</wicri:noCountry></affiliation><affiliation><nlm:aff id="af3"><addr-line>Division of Infectious Diseases, Department of Medicine</addr-line></nlm:aff><wicri:noCountry code="subfield">Department of Medicine</wicri:noCountry></affiliation></author><author><name sortKey="Blumberg, Henry M" sort="Blumberg, Henry M" uniqKey="Blumberg H" first="Henry M." last="Blumberg">Henry M. Blumberg</name><affiliation><nlm:aff id="af1"><institution>Emory University School of Medicine</institution></nlm:aff></affiliation><affiliation><nlm:aff id="af2"><addr-line>Departments of Epidemiology and Global Health, Rollins School of Public Health</addr-line></nlm:aff><wicri:noCountry code="subfield">Rollins School of Public Health</wicri:noCountry></affiliation><affiliation><nlm:aff id="af3"><addr-line>Division of Infectious Diseases, Department of Medicine</addr-line></nlm:aff><wicri:noCountry code="subfield">Department of Medicine</wicri:noCountry></affiliation></author><author><name sortKey="Leonard, Michael K" sort="Leonard, Michael K" uniqKey="Leonard M" first="Michael K." last="Leonard">Michael K. Leonard</name><affiliation><nlm:aff id="af1"><institution>Emory University School of Medicine</institution></nlm:aff></affiliation><affiliation><nlm:aff id="af3"><addr-line>Division of Infectious Diseases, Department of Medicine</addr-line></nlm:aff><wicri:noCountry code="subfield">Department of Medicine</wicri:noCountry></affiliation></author><author><name sortKey="Kraft, Colleen S" sort="Kraft, Colleen S" uniqKey="Kraft C" first="Colleen S." last="Kraft">Colleen S. Kraft</name><affiliation><nlm:aff id="af1"><institution>Emory University School of Medicine</institution></nlm:aff></affiliation><affiliation><nlm:aff id="af3"><addr-line>Division of Infectious Diseases, Department of Medicine</addr-line></nlm:aff><wicri:noCountry code="subfield">Department of Medicine</wicri:noCountry></affiliation><affiliation wicri:level="2"><nlm:aff id="af4"><addr-line>Department of Pathology and Laboratory Medicine</addr-line>,<institution>Emory University</institution>,<addr-line>Atlanta, GA</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Géorgie (États-Unis)</region></placeName><wicri:cityArea>Atlanta</wicri:cityArea></affiliation></author></analytic><series><title level="j">Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America</title><idno type="ISSN">1058-4838</idno><idno type="eISSN">1537-6591</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The site of extrapulmonary tuberculosis infection has a known effect on mortality. Authors use a large clinical case series to identify previously unconfirmed risk factors that are associated with site of extrapulmonary tuberculosis infection.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Clin Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">Clin. Infect. Dis</journal-id><journal-id journal-id-type="publisher-id">cid</journal-id><journal-id journal-id-type="hwp">cid</journal-id><journal-title-group><journal-title>Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America</journal-title></journal-title-group><issn pub-type="ppub">1058-4838</issn><issn pub-type="epub">1537-6591</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">22423123</article-id><article-id pub-id-type="pmc">3493181</article-id><article-id pub-id-type="doi">10.1093/cid/cis303</article-id><article-id pub-id-type="publisher-id">cis303</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles and Commentaries</subject></subj-group></article-categories><title-group><article-title>Site of Extrapulmonary Tuberculosis is Associated with HIV Infection</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Leeds</surname><given-names>Ira L.</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Magee</surname><given-names>Matthew J.</given-names></name><xref ref-type="aff" rid="af2">2</xref></contrib><contrib contrib-type="author"><name><surname>Kurbatova</surname><given-names>Ekaterina V.</given-names></name><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>del Rio</surname><given-names>Carlos</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Blumberg</surname><given-names>Henry M.</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af2">2</xref><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Leonard</surname><given-names>Michael K.</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Kraft</surname><given-names>Colleen S.</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af3">3</xref><xref ref-type="aff" rid="af4">4</xref></contrib></contrib-group><aff id="af1"><label>1</label><institution>Emory University School of Medicine</institution></aff><aff id="af2"><label>2</label><addr-line>Departments of Epidemiology and Global Health, Rollins School of Public Health</addr-line></aff><aff id="af3"><label>3</label><addr-line>Division of Infectious Diseases, Department of Medicine</addr-line></aff><aff id="af4"><label>4</label><addr-line>Department of Pathology and Laboratory Medicine</addr-line>,<institution>Emory University</institution>,<addr-line>Atlanta, GA</addr-line></aff><author-notes><corresp>Correspondence: Ira Leeds, AB, Emory University School of Medicine, 1648 Pierce Drive, Atlanta, GA 30322 (<email>ileeds@emory.edu</email>).</corresp></author-notes><pub-date pub-type="ppub"><day>1</day><month>7</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>15</day><month>3</month><year>2012</year></pub-date><volume>55</volume><issue>1</issue><fpage>75</fpage><lpage>81</lpage><history><date date-type="received"><day>6</day><month>12</month><year>2011</year></date><date date-type="accepted"><day>23</day><month>2</month><year>2012</year></date></history><permissions><copyright-statement>© The Author 2012. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.</copyright-statement><copyright-year>2012</copyright-year></permissions><self-uri content-type="pdf" xlink:type="simple" xlink:href="cis303.pdf"></self-uri><abstract abstract-type="precis"><p>The site of extrapulmonary tuberculosis infection has a known effect on mortality. Authors use a large clinical case series to identify previously unconfirmed risk factors that are associated with site of extrapulmonary tuberculosis infection.</p></abstract><abstract><p><bold><italic>Background.</italic></bold> In the United States, the proportion of patients with extrapulmonary tuberculosis (EPTB) has increased relative to cases of pulmonary tuberculosis. Patients with central nervous system (CNS)/meningeal and disseminated EPTB and those with human immunodeficiency virus (HIV)/AIDS have increased mortality. The purpose of our study was to determine risk factors associated with particular types of EPTB.</p><p><bold><italic>Methods.</italic></bold> We retrospectively reviewed 320 cases of EPTB from 1995–2007 at a single urban US public hospital. Medical records were reviewed to determine site of EPTB and patient demographic and clinical characteristics. Multivariable logistic regression analyses were performed to determine independent associations between patient characteristics and site of disease.</p><p><bold><italic>Results.</italic></bold> Patients were predominantly male (67%), African American (82%), and US-born (76%). Mean age was 40 years (range 18–89). The most common sites of EPTB were lymphatic (28%), disseminated (23%), and CNS/meningeal (22%) disease. One hundred fifty-four (48.1%) were HIV-infected, 40% had concomitant pulmonary tuberculosis, and 14.7% died within 12 months of EPTB diagnosis. Multivariable analysis demonstrated that HIV-infected patients were less likely to have pleural (adjusted odds ratio [AOR] 0.3; 95% confidence interval [CI] .2, .6) as site of EPTB disease than HIV-uninfected patients. Among patients with EPTB and HIV-infection, patients with CD4 lymphocyte cell count <100 were more likely to have severe forms of EPTB (CNS/meningeal and/or disseminated) (AOR 1.6; 95% CI, 1.0, 2.4).</p><p><bold><italic>Conclusions.</italic></bold> Among patients hospitalized with EPTB, patients coinfected with HIV and low CD4 counts were more likely to have CNS/meningeal and disseminated disease. Care for similar patients should include consideration of these forms of EPTB since they carry a high risk of death.</p></abstract><counts><page-count count="7"></page-count></counts></article-meta></front></pmc><affiliations><list><country><li>États-Unis</li></country><region><li>Géorgie (États-Unis)</li></region></list><tree><noCountry><name sortKey="Blumberg, Henry M" sort="Blumberg, Henry M" uniqKey="Blumberg H" first="Henry M." last="Blumberg">Henry M. Blumberg</name><name sortKey="Del Rio, Carlos" sort="Del Rio, Carlos" uniqKey="Del Rio C" first="Carlos" last="Del Rio">Carlos Del Rio</name><name sortKey="Kurbatova, Ekaterina V" sort="Kurbatova, Ekaterina V" uniqKey="Kurbatova E" first="Ekaterina V." last="Kurbatova">Ekaterina V. Kurbatova</name><name sortKey="Leeds, Ira L" sort="Leeds, Ira L" uniqKey="Leeds I" first="Ira L." last="Leeds">Ira L. Leeds</name><name sortKey="Leonard, Michael K" sort="Leonard, Michael K" uniqKey="Leonard M" first="Michael K." last="Leonard">Michael K. Leonard</name><name sortKey="Magee, Matthew J" sort="Magee, Matthew J" uniqKey="Magee M" first="Matthew J." last="Magee">Matthew J. Magee</name></noCountry><country name="États-Unis"><region name="Géorgie (États-Unis)"><name sortKey="Kraft, Colleen S" sort="Kraft, Colleen S" uniqKey="Kraft C" first="Colleen S." last="Kraft">Colleen S. Kraft</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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