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Memórias do Instituto Oswaldo Cruz
Fundação Oswaldo Cruz, Fiocruz
ISSN: 1678-8060
EISSN: 1678-8060
Vol. 97, No. 8, 2002, pp. 1225-1230
Bioline Code: oc02262
Full paper language: English
Document type: Research Article
Document available free of charge

Memórias do Instituto Oswaldo Cruz, Vol. 97, No. 8, 2002, pp. 1225-1230

 en Clinical Presentation and Survival of Smear-positive Pulmonary Tuberculosis Patients of a University General Hospital in a Developing Country
Anna CC Carvalho; Zoelete B Nunes; Marneili Martins; Rodrigo OC Araújo; Mario Comelli; Alessandra Marinoni & Afrânio L Kritski

Abstract

From January 1995 to August 1997 we evaluated prospectively the clinical presentation, laboratory findings and short-term survival of smear-positive pulmonary tuberculosis (TB) patients who sought care at our hospital. After providing informed, written consent, the patients were interviewed and laboratory tests were performed. Information about survivorship and death was collected through September 1998. Eighty-six smear-positive pulmonary TB patients were enrolled; 26.7% were HIV-seropositive. Seventeen HIV-seronegative pulmonary TB patients (19.8%) presented chronic diseases in addition to TB. In the multiple logistic regression analysis a CD4+ cell count ≤ 200 cell/mm3 was independently associated with HIV seropositivity. In the Cox regression model, fitted to all patients, HIV seropositivity and age ≥ 50 years were independently associated with decreased survival. Among HIV-seronegative persons, the presence of an additional disease increased the risk of death of almost six-fold. Use of antiretroviral drugs was associated with a lower risk of death among HIV-seropositive smear-positive pulmonary TB patients (RH = 0.32, 95% CI 0.10-0.92). In our study smear-positive pulmonary TB patients had a low short-term survival rate that was strongly associated with HIV infection, age and co-morbidities. Therapy with antiretroviral drugs reduced the short-term risk of death among HIV-seropositive patients after TB diagnosis.

Keywords
tuberculosis - HIV infection - survival

 
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