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