Tuberculosis incidence and risk factors among patients living with HIV/AIDS in public health service institutions in Brasilia, Federal District / Incidência e fatores de risco para tuberculose em pacientes vivendo com HIV/AIDS atendidos nos serviços públicos de saúde em Brasília, Distrito Federal
Rev. Soc. Bras. Med. Trop
; 41(6): 549-555, Nov.-Dec. 2008. graf, tab
Article
in En
| LILACS
| ID: lil-502032
Responsible library:
BR1.1
ABSTRACT
In order to estimate the incidence of and risk factors for developing tuberculosis, the clinical charts of a retrospective cohort of 281 HIV-positive adults, who were notified to the AIDS Program of the Health Department of Brasilia in 1998, were reviewed in 2003. All the patients were treatment-naive regarding antiretroviral therapy at the time of inclusion in the cohort. Twenty-nine patients were identified as having tuberculosis at the start of the study. Thirteen incident tuberculosis cases were identified during the 60 months of follow-up, with an incidence density rate of 1.24/100 person-years. Tuberculosis incidence was highest among patients with baseline CD4+ T-lymphocyte counts < 200 cells/µl who were not using antiretroviral therapy (incidence = 5.47; 95 percent CI = 2.73 to 10.94). Multivariate analysis showed that baseline CD4+ T-lymphocyte counts < 200 cells/µl (adjusted hazard ratio [AHR] = 5.09; 95 percent CI = 1.27 to 20.37; p = 0.02) and non-use of antiretroviral therapy (AHR = 12.17; 95 percent CI = 2.6 to 56.90; p = 0.001) were independently associated with increased risk of tuberculosis.
RESUMO
Para estimar a incidência e os fatores de risco para desenvolver tuberculose foram revisados em 2003 os < prontuários de uma coorte retrospectiva de 281 adultos infectados pelo HIV que foram notificados ao Programa de Aids da Secretaria de Saúde de Brasília em 1998. Todos os pacientes eram virgens de tratamento anti-retroviral no momento da inclusão na coorte. Vinte e nove pacientes foram identificados com tuberculose na avaliação basal. Treze casos incidentes de tuberculose foram identificados durante os 60 meses de seguimento com densidade de incidência de 1,24/100 pessoas-ano. A incidência de tuberculose foi maior em pacientes com contagens basal de linfócitos T CD4+ < 200 células/µl que não se encontravam em uso de terapia anti-retroviral 5,47 (IC95 por cento=2,73 a 10,94). A análise multivariada demonstrou que a contagem basal de linfócitos T CD4+ < 200 células/µl (adjusted hazard ratio [AHR] =5,09; IC95 por cento=1,27 to 20,37; p =0,02) e o não uso de terapia anti-retroviral (AHR=12,17; IC95 por cento=2,6 to 56,90; p=0,001) estiveram independentemente associados a um risco maior de tuberculose.
Key words
Full text:
1
Index:
LILACS
Main subject:
Tuberculosis, Pulmonary
/
AIDS-Related Opportunistic Infections
/
Antiretroviral Therapy, Highly Active
Type of study:
Clinical_trials
/
Etiology_studies
/
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Adult
/
Female
/
Humans
/
Male
Country/Region as subject:
America do sul
/
Brasil
Language:
En
Journal:
Rev. Soc. Bras. Med. Trop
Journal subject:
MEDICINA TROPICAL
Year:
2008
Type:
Article