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Factors associated with early mortality in HIV-positive men and women investigated for tuberculosis at Ethiopian health centers

Reepalu, Anton LU ; Balcha, Taye Tolera LU ; Skogmar, Sten LU ; Güner, Nuray; Sturegård, Erik LU and Björkman, Per LU (2016) In PLoS One 11(6).
Abstract

Despite increasing access to antiretroviral treatment (ART) in low-income countries, HIV-related mortality is high, especially in the first months following ART initiation. We aimed to evaluate the impact of TB coinfection on early mortality and to assess gender-specific predictors of mortality in a cohort of Ethiopian adults subjected to intensified casefinding for active TB before starting ART. Material and Methods: Prospectively recruited ART-eligible adults (n = 812, 58.6% female) at five Ethiopian health centers were followed for 6 months. At inclusion sputum culture, Xpert MTB/RIF, and smear microscopy were performed (158/812 [19.5%] had TB). Primary outcome was all-cause mortality. We used multivariate Cox models to identify... (More)

Despite increasing access to antiretroviral treatment (ART) in low-income countries, HIV-related mortality is high, especially in the first months following ART initiation. We aimed to evaluate the impact of TB coinfection on early mortality and to assess gender-specific predictors of mortality in a cohort of Ethiopian adults subjected to intensified casefinding for active TB before starting ART. Material and Methods: Prospectively recruited ART-eligible adults (n = 812, 58.6% female) at five Ethiopian health centers were followed for 6 months. At inclusion sputum culture, Xpert MTB/RIF, and smear microscopy were performed (158/812 [19.5%] had TB). Primary outcome was all-cause mortality. We used multivariate Cox models to identify predictors of mortality. Results: In total, 37/812 (4.6%) participants died, 12 (32.4%) of whom had TB. Karnofsky performance score (KPS) and mid-upper arm circumference (MUAC) were associated with mortality in the whole population. However, the associations were different in men and women. In men, only MUAC remained associated with mortality (adjusted hazard ratio [aHR] 0.71 [95% CI 0.57-0.88]). In women, KPS

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
PLoS One
volume
11
issue
6
publisher
Public Library of Science
external identifiers
  • Scopus:84975295529
ISSN
1932-6203
DOI
10.1371/journal.pone.0156602
language
English
LU publication?
yes
id
4b378ca9-8410-4902-a94e-c4ff788e06d0
date added to LUP
2016-07-08 08:47:05
date last changed
2016-09-20 03:08:26
@misc{4b378ca9-8410-4902-a94e-c4ff788e06d0,
  abstract     = {<p>Despite increasing access to antiretroviral treatment (ART) in low-income countries, HIV-related mortality is high, especially in the first months following ART initiation. We aimed to evaluate the impact of TB coinfection on early mortality and to assess gender-specific predictors of mortality in a cohort of Ethiopian adults subjected to intensified casefinding for active TB before starting ART. Material and Methods: Prospectively recruited ART-eligible adults (n = 812, 58.6% female) at five Ethiopian health centers were followed for 6 months. At inclusion sputum culture, Xpert MTB/RIF, and smear microscopy were performed (158/812 [19.5%] had TB). Primary outcome was all-cause mortality. We used multivariate Cox models to identify predictors of mortality. Results: In total, 37/812 (4.6%) participants died, 12 (32.4%) of whom had TB. Karnofsky performance score (KPS) and mid-upper arm circumference (MUAC) were associated with mortality in the whole population. However, the associations were different in men and women. In men, only MUAC remained associated with mortality (adjusted hazard ratio [aHR] 0.71 [95% CI 0.57-0.88]). In women, KPS </p>},
  author       = {Reepalu, Anton and Balcha, Taye Tolera and Skogmar, Sten and Güner, Nuray and Sturegård, Erik and Björkman, Per},
  issn         = {1932-6203},
  language     = {eng},
  month        = {06},
  number       = {6},
  publisher    = {ARRAY(0xb897790)},
  series       = {PLoS One},
  title        = {Factors associated with early mortality in HIV-positive men and women investigated for tuberculosis at Ethiopian health centers},
  url          = {http://dx.doi.org/10.1371/journal.pone.0156602},
  volume       = {11},
  year         = {2016},
}