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Abstract: Poster Presentations |

THE IMPACT OF ACTIVE TUBERCULOSIS DISEASE ON SURVIVAL OF HUMAN IMMUNODEFICIENCY VIRUS-INFECTED INDIVIDUALS FREE TO VIEW

Oana C. Arghir; Camelia Ciobotaru; Sorin Rugina
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Clinical Pneumology hospital, Constanta, Romania


Chest


Chest. 2009;136(4_MeetingAbstracts):71S-b-72S. doi:10.1378/chest.136.4_MeetingAbstracts.71S-b
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Abstract

PURPOSE:  Constantza is an endemic area of tuberculosis (TB) and a prevalent region for HIV/AIDS in Romania. Few studies examined the impact of active TB on the survival of HIV infected persons.

METHODS:  Between 1989 and 2006, all patients presenting medical recordings of HIV-1 infection +/− TB disease were retrospectively reviewed. Survival was analyzed with Kaplan Meier method and Cox proportional hazard model (confidence interval = 95%) exploring two groups of HIV-1 seropositive individuals (with or without active TB disease).

RESULTS:  Of the 771 reported HIV-1 cases from January 1989 to December 2006, 527 (68.35%) had available medical files. 268 of these (50.85%), mean aged 13.14 +/− 14.32 yrs, developed TB. Overall mortality rate was greater in TB group (104/268 or 38.8%) versus those without TB (26/259 or 10.03%; OR = 3.87; 2.38 < OR < 6.31; RR = 3.06; 2.05 < RR < 4.85; chi2 = 36.01; p < 0.0001) (n = 130 with mortality data, mean aged 16.2 +/− 16.89 yrs). 70% of the deaths were reported till the end of 1996 (n = 91/130)when anti-retroviral therapy was not routinely available. Mean survival times was greater in those with TB (85.721 +/− 4.602 months versus 50.085 +/− 2.176). In this group, patients had a median survival of 57.0 +/− 6.736 months, as compared to 43.0 +/− 3.336 months for HIV without TB. Survival between HIV patients with different forms of TB disease was similar for those with pulmonary and extrapulmonary TB (29.881 +/− 6.529 months; 30.250 +/− 4.904 months), being greater compared to severe disseminative TB (11.300 +/− 1.882 months; Kaplan Meier log rank chi2 = 146.964, p < 0.0001).

CONCLUSION:  TB disease, especially disseminated forms, affectes survival outcomes among HIV-1 infected persons. These results seem to underscore the importance of therapy for TB in prolonging survival among HIV infected patients.

CLINICAL IMPLICATIONS:  Both routine screening and preventive therapy for TB are important in prolonging survival among HIV infected patients in countries where HIV and TB are endemic and where anti-retroviral therapy is not routinely available.

DISCLOSURE:  Oana Arghir, No Financial Disclosure Information; No Product/Research Disclosure Information

Tuesday, November 3, 2009

12:45 PM - 2:00 PM


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