Clinical deterioration during antituberculosis treatment in Africa: incidence, causes and risk factors.
Identifieur interne : 000587 ( PubMed/Curation ); précédent : 000586; suivant : 000588Clinical deterioration during antituberculosis treatment in Africa: incidence, causes and risk factors.
Auteurs : Dominique J. Pepper [Afrique du Sud] ; Suzaan Marais ; Robert J. Wilkinson ; Feriyl Bhaijee ; Gary Maartens ; Helen Mcilleron ; Virginia De Azevedo ; Helen Cox ; Cheryl Mcdermid ; Simiso Sokhela ; Janisha Patel ; Graeme MeintjesSource :
- BMC infectious diseases [ 1471-2334 ] ; 2010.
Descripteurs français
- KwdFr :
- Afrique, Agents antiVIH (usage thérapeutique), Antituberculeux (usage thérapeutique), Comorbidité, Facteurs de risque, Humains, Incidence, Infections à VIH (), Infections à VIH (anatomopathologie), Infections à VIH (mortalité), Infections à VIH (virologie), Numération des lymphocytes CD4, Thérapie antirétrovirale hautement active, Tuberculose (anatomopathologie), Tuberculose (mortalité), Tuberculose (traitement médicamenteux), VIH-1 (Virus de l'Immunodéficience Humaine de type 1) (isolement et purification), Échec thérapeutique, Études de cohortes, Études prospectives.
- MESH :
- anatomopathologie : Infections à VIH, Tuberculose.
- isolement et purification : VIH-1 (Virus de l'Immunodéficience Humaine de type 1).
- mortalité : Infections à VIH, Tuberculose.
- traitement médicamenteux : Tuberculose.
- usage thérapeutique : Agents antiVIH, Antituberculeux.
- virologie : Infections à VIH.
- Afrique, Comorbidité, Facteurs de risque, Humains, Incidence, Infections à VIH, Numération des lymphocytes CD4, Thérapie antirétrovirale hautement active, Échec thérapeutique, Études de cohortes, Études prospectives.
English descriptors
- KwdEn :
- Africa, Anti-HIV Agents (therapeutic use), Antiretroviral Therapy, Highly Active, Antitubercular Agents (therapeutic use), CD4 Lymphocyte Count, Cohort Studies, Comorbidity, HIV Infections (complications), HIV Infections (mortality), HIV Infections (pathology), HIV Infections (virology), HIV-1 (isolation & purification), Humans, Incidence, Prospective Studies, Risk Factors, Treatment Failure, Tuberculosis (drug therapy), Tuberculosis (mortality), Tuberculosis (pathology).
- MESH :
- chemical , therapeutic use : Anti-HIV Agents, Antitubercular Agents.
- geographic : Africa.
- complications : HIV Infections.
- drug therapy : Tuberculosis.
- isolation & purification : HIV-1.
- mortality : HIV Infections, Tuberculosis.
- pathology : HIV Infections, Tuberculosis.
- virology : HIV Infections.
- Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Cohort Studies, Comorbidity, Humans, Incidence, Prospective Studies, Risk Factors, Treatment Failure.
Abstract
HIV-1 and Mycobacterium tuberculosis cause substantial morbidity and mortality. Despite the availability of antiretroviral and antituberculosis treatment in Africa, clinical deterioration during antituberculosis treatment remains a frequent reason for hospital admission. We therefore determined the incidence, causes and risk factors for clinical deterioration.
DOI: 10.1186/1471-2334-10-83
PubMed: 20353569
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l'Immunodéficience Humaine de type 1) (isolement et purification)</term><term>Échec thérapeutique</term><term>Études de cohortes</term><term>Études prospectives</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-HIV Agents</term><term>Antitubercular Agents</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Africa</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Infections à VIH</term><term>Tuberculose</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>HIV Infections</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Tuberculosis</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>HIV-1</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>VIH-1 (Virus de l'Immunodéficience Humaine de type 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Studies</term><term>Comorbidity</term><term>Humans</term><term>Incidence</term><term>Prospective Studies</term><term>Risk Factors</term><term>Treatment Failure</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Afrique</term><term>Comorbidité</term><term>Facteurs de risque</term><term>Humains</term><term>Incidence</term><term>Infections à VIH</term><term>Numération des lymphocytes CD4</term><term>Thérapie antirétrovirale hautement active</term><term>Échec thérapeutique</term><term>Études de cohortes</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">HIV-1 and Mycobacterium tuberculosis cause substantial morbidity and mortality. Despite the availability of antiretroviral and antituberculosis treatment in Africa, clinical deterioration during antituberculosis treatment remains a frequent reason for hospital admission. We therefore determined the incidence, causes and risk factors for clinical deterioration.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">20353569</PMID><DateCreated><Year>2010</Year><Month>04</Month><Day>23</Day></DateCreated><DateCompleted><Year>2010</Year><Month>05</Month><Day>10</Day></DateCompleted><DateRevised><Year>2017</Year><Month>09</Month><Day>22</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2334</ISSN><JournalIssue CitedMedium="Internet"><Volume>10</Volume><PubDate><Year>2010</Year><Month>Mar</Month><Day>30</Day></PubDate></JournalIssue><Title>BMC infectious diseases</Title><ISOAbbreviation>BMC Infect. Dis.</ISOAbbreviation></Journal><ArticleTitle>Clinical deterioration during antituberculosis treatment in Africa: incidence, causes and risk factors.</ArticleTitle><Pagination><MedlinePgn>83</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/1471-2334-10-83</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">HIV-1 and Mycobacterium tuberculosis cause substantial morbidity and mortality. Despite the availability of antiretroviral and antituberculosis treatment in Africa, clinical deterioration during antituberculosis treatment remains a frequent reason for hospital admission. We therefore determined the incidence, causes and risk factors for clinical deterioration.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Prospective cohort study of 292 adults who initiated antituberculosis treatment during a 3-month period. We evaluated those with clinical deterioration over the following 24 weeks of treatment.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Seventy-one percent (209/292) of patients were HIV-1 infected (median CD4+: 129 cells/microL [IQR:62-277]). At tuberculosis diagnosis, 23% (34/145) of HIV-1 infected patients qualifying for antiretroviral treatment (ART) were receiving ART; 6 months later, 75% (109/145) had received ART. Within 24 weeks of initiating antituberculosis treatment, 40% (117/292) of patients experienced clinical deterioration due to co-morbid illness (n = 70), tuberculosis related illness (n = 47), non AIDS-defining HIV-1 related infection (n = 25) and AIDS-defining illness (n = 21). Using HIV-1 uninfected patients as the referent group, HIV-1 infected patients had an increasing risk of clinical deterioration as CD4+ counts decreased [CD4+>350 cells/microL: RR = 1.4, 95% CI = 0.7-2.9; CD4+:200-350 cells/microL: RR = 2.0, 95% CI = 1.1-3.6; CD4+<200 cells/microL: RR = 3.0, 95% CI = 1.9-4.7]. During follow-up, 26% (30/117) of patients with clinical deterioration required hospital admission and 15% (17/117) died. Fifteen deaths were in HIV-1 infected patients with a CD4+<200 cells/microL.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">In multivariate analysis, HIV-1 infection and a low CD4+ count at tuberculosis diagnosis were significant risk factors for clinical deterioration and death. The initiation of ART at a CD4+ count of <350 cells/microL will likely reduce the high burden of clinical deterioration.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Pepper</LastName><ForeName>Dominique J</ForeName><Initials>DJ</Initials><AffiliationInfo><Affiliation>Infectious Diseases Unit, GF Jooste Hospital, Cape Town, South Africa. dominiquepepper@gmail.com</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Marais</LastName><ForeName>Suzaan</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Wilkinson</LastName><ForeName>Robert J</ForeName><Initials>RJ</Initials></Author><Author ValidYN="Y"><LastName>Bhaijee</LastName><ForeName>Feriyl</ForeName><Initials>F</Initials></Author><Author ValidYN="Y"><LastName>Maartens</LastName><ForeName>Gary</ForeName><Initials>G</Initials></Author><Author ValidYN="Y"><LastName>McIlleron</LastName><ForeName>Helen</ForeName><Initials>H</Initials></Author><Author ValidYN="Y"><LastName>De Azevedo</LastName><ForeName>Virginia</ForeName><Initials>V</Initials></Author><Author ValidYN="Y"><LastName>Cox</LastName><ForeName>Helen</ForeName><Initials>H</Initials></Author><Author ValidYN="Y"><LastName>McDermid</LastName><ForeName>Cheryl</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Sokhela</LastName><ForeName>Simiso</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Patel</LastName><ForeName>Janisha</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Meintjes</LastName><ForeName>Graeme</ForeName><Initials>G</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>1U2RTW007370</GrantID><Agency>PHS HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>WT 084323</GrantID><Agency>Wellcome Trust</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>1U2RTW007373-01A1</GrantID><Agency>PHS HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>WT 088316</GrantID><Agency>Wellcome Trust</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>WT 081667</GrantID><Agency>Wellcome Trust</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>088316</GrantID><Agency>Wellcome Trust</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>MC_U117588499</GrantID><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>084323</GrantID><Agency>Wellcome Trust</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>072070</GrantID><Agency>Wellcome Trust</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>U117588499(88499)</GrantID><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType><PublicationType UI="D013486">Research Support, U.S. Gov't, Non-P.H.S.</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2010</Year><Month>03</Month><Day>30</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Infect Dis</MedlineTA><NlmUniqueID>100968551</NlmUniqueID><ISSNLinking>1471-2334</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D019380">Anti-HIV Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000995">Antitubercular Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>AIDS. 2002 Jan 4;16(1):75-83</RefSource><PMID Version="1">11741165</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lancet. 2009 Sep 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20;18(2):89-94</RefSource><PMID Version="1">11839141</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000349" MajorTopicYN="N" Type="Geographic">Africa</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019380" MajorTopicYN="N">Anti-HIV Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D023241" MajorTopicYN="N">Antiretroviral Therapy, Highly Active</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000995" MajorTopicYN="N">Antitubercular Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018791" MajorTopicYN="N">CD4 Lymphocyte Count</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015897" MajorTopicYN="N">Comorbidity</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015658" MajorTopicYN="N">HIV Infections</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015497" MajorTopicYN="N">HIV-1</DescriptorName><QualifierName UI="Q000302" MajorTopicYN="N">isolation & purification</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015994" MajorTopicYN="N">Incidence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk 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PubStatus="pubmed"><Year>2010</Year><Month>4</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2010</Year><Month>5</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">20353569</ArticleId><ArticleId IdType="pii">1471-2334-10-83</ArticleId><ArticleId IdType="doi">10.1186/1471-2334-10-83</ArticleId><ArticleId IdType="pmc">PMC2858733</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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