RESUMO
Background The main cause of death in HIV patients is tuberculosis (TB). However, few Latin American studies have evaluated the prognosis of patients with coinfection. Aim To determine the factors associated with survival in patients with HIV-TB coinfection treated at a Peruvian referral hospital. Methods A retrospective cohort study was performed based on clinical records of patients treated at the Department of Infectious Diseases in the Arzobispo Loayza National Hospital from 2004 to 2012. Survival was assessed using the Kaplan-Meier estimator and Cox Proportional Hazard Model. Results From 315 patients, 82 died during the follow-up. The mean of follow for each patient was 730 days. The multivariate analysis showed that receiving HAART (HR: 0,31; IC: 0,20-0,50; p < 0,01) and having more weight (HR: 0,96; IC 0,94-0,98; p < 0,01) when the coinfection was diagnosed, were protective factors; while having a pathology different from TB (HR: 1,88; IC: 1,19-2,98; p < 0,01), age in years (HR: 1,76; IC: 1,12-2,74; p ≤ 0,01) and being hospitalized when diagnosed with TB (HR: 1,69; IC 1,02-2,80; p < 0,04) were associated with lower survival. Discussion Receiving HAART and having more weight when the coinfection is diagnosed were associated with a higher chance of survival.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/mortalidade , Coinfecção/mortalidade , Tuberculose/mortalidade , Tuberculose/virologia , Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Adulto , Terapia Antirretroviral de Alta Atividade , Contagem de Linfócito CD4 , Coinfecção/tratamento farmacológico , Feminino , Mortalidade Hospitalar , Humanos , Estimativa de Kaplan-Meier , Masculino , Peru/epidemiologia , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Tuberculose/tratamento farmacológico , Carga ViralRESUMO
Resumen Introducción La principal causa de muerte en pacientes infectados con VIH es la tuberculosis (TBC). Pocos estudios latinoamericanos han evaluado la sobrevida de pacientes co-infectados. Objetivo Determinar factores asociados a sobrevida en pacientes con co-infección VIH-TBC atendidos en un hospital peruano. Materiales y Métodos Estudio de cohorte, retrospectivo, en base a registros clínicos de pacientes atendidos en el Servicio de Infectología del Hospital Nacional Arzobispo Loayza durante los años 2004-2012. Se evaluó la sobrevida de 315 pacientes, utilizando las curvas de Kaplan-Meier y el método de Riesgos Proporcionales de Cox. Resultados De 315 pacientes, 82 murieron durante el seguimiento. La mediana de seguimiento para cada participante fue de 730 días. El análisis multivariado mostró que recibir TARGA (HR: 0,31; IC: 0,20-0,50; p < 0,01) y tener mayor peso (HR: 0,96; IC 0,94-0,98; p < 0,01) al momento del diagnóstico de la co-infección fueron factores protectores; mientras que tener una patología distinta a TBC (HR: 1,88; IC: 1,19-2,98; p < 0,01), edad mayor a 34 años (HR: 1,76; IC: 1,12-2,74; p ≤ 0,01), y estar hospitalizado al momento del diagnóstico (HR: 1,69; IC 1,02-2,80; p < 0,04) se asociaron a menor sobrevida. Discusión Recibir TARGA y tener mayor peso al momento del diagnóstico de la coinfección se asociaron a mayor sobrevida.
Background The main cause of death in HIV patients is tuberculosis (TB). However, few Latin American studies have evaluated the prognosis of patients with coinfection. Aim To determine the factors associated with survival in patients with HIV-TB coinfection treated at a Peruvian referral hospital. Methods A retrospective cohort study was performed based on clinical records of patients treated at the Department of Infectious Diseases in the Arzobispo Loayza National Hospital from 2004 to 2012. Survival was assessed using the Kaplan-Meier estimator and Cox Proportional Hazard Model. Results From 315 patients, 82 died during the follow-up. The mean of follow for each patient was 730 days. The multivariate analysis showed that receiving HAART (HR: 0,31; IC: 0,20-0,50; p < 0,01) and having more weight (HR: 0,96; IC 0,94-0,98; p < 0,01) when the coinfection was diagnosed, were protective factors; while having a pathology different from TB (HR: 1,88; IC: 1,19-2,98; p < 0,01), age in years (HR: 1,76; IC: 1,12-2,74; p ≤ 0,01) and being hospitalized when diagnosed with TB (HR: 1,69; IC 1,02-2,80; p < 0,04) were associated with lower survival. Discussion Receiving HAART and having more weight when the coinfection is diagnosed were associated with a higher chance of survival.