Changes in tuberculosis in human immunodeficiency virus infected patients in a Spanish tertiary hospital (1995-2013).
Rev Esp Quimioter
; 31(4): 329-335, 2018 Aug.
Article
in En
| MEDLINE
| ID: mdl-29963817
ABSTRACT
OBJECTIVE:
Although the incidence of human immunodeficiency virus (HIV)-associated tuberculosis (TB) has decreased, changes in other characteristics of the disease are largely unknown. To describe the trends in TB in patients infected with HIV from 1995 to 2013.METHODS:
We review all cases of TB in a tertiary hospital in Madrid, Spain.RESULTS:
Among 1,284 patients diagnosed of TB, 298 (23%) were coinfected with HIV. The prevalence of HIV infection during the period of study has decreased from 40% to 14% (p for the trend < 0.001). Clinical presentation has also changed. Although pulmonary and extrapulmonary TB has remained unchanged, miliary presentation has significantly decreased (from 36% to 22%, p = 0.005). The 4-drug regimen was the preferable scheme, with higher implementation at the end of the study period (82% from 1995-1999 to 95% in 2010-2013, p = 0.43). Factors such as treatment failure (OR 11.7; CI 95% 3.12-44.1) and miliary form (OR 2.8; CI 95%; 1.09-7.3) were independently associated with TB related mortality, while the longer duration of treatment was as a protective factor (OR 0.7; CI 95% 0.6-0.8).CONCLUSIONS:
HIV has decreased very significantly as a risk factor for the development of TB. Despite improvement in the treatment of both TB and HIV, and in overall mortality, deaths attributable to the disease in this population remain high mostly in miliary and relapsing forms.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tuberculosis
/
HIV Infections
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Rev Esp Quimioter
Journal subject:
TERAPIA POR MEDICAMENTOS
Year:
2018
Document type:
Article