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Titolo:
Changing clinical presentation and survival in HIV-associated tuberculosisafter highly active antiretroviral therapy
Autore:
Girardi, E; Palmieri, F; Cingolani, A; Ammassari, A; Petrosillo, N; Gillini, L; Zinzi, D; De Luca, A; Antinori, A; Ippolito, G;
Indirizzi:
IRCCS, Dipartimento Epidemiol, Inst Nazl Malattie Infett Lazzaro Spallanzani, I-00149 Rome, Italy IRCCS Rome Italy I-00149 Infett Lazzaro Spallanzani, I-00149 Rome, Italy Catholic Univ Sacred Heart, Dept Infect Dis, I-00168 Rome, Italy Catholic Univ Sacred Heart Rome Italy I-00168 t Dis, I-00168 Rome, Italy
Titolo Testata:
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
fascicolo: 4, volume: 26, anno: 2001,
pagine: 326 - 331
SICI:
1525-4135(20010401)26:4<326:CCPASI>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
IMMUNODEFICIENCY-VIRUS INFECTION; PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY; CD4 CELL COUNT; CYTOMEGALOVIRUS RETINITIS; PULMONARY TUBERCULOSIS; INCREASING SURVIVAL; AIDS PATIENTS; ERA; INITIATION; PREDICTORS;
Keywords:
HIV; associated pulmonary tuberculosis; HAART; Clinical presentation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Girardi, E IRCCS, Dipartimento Epidemiol, Inst Nazl Malattie Infett Lazzaro Spallanzani, Via Portuense 292, I-00149 Rome, Italy IRCCS Via Portuense 292 Rome Italy I-00149 I-00149 Rome, Italy
Citazione:
E. Girardi et al., "Changing clinical presentation and survival in HIV-associated tuberculosisafter highly active antiretroviral therapy", J ACQ IMM D, 26(4), 2001, pp. 326-331

Abstract

Objective: To assess changes in clinical presentation and outcome of HIV-associated tuberculosis (TB) before and after widespread implementation of highly active antiretroviral therapy (HAART). Methods: We reviewed clinical charts of HIV-infected patients with cultureconfirmed pulmonary TB in two referral clinical centers in Rome, Italy. The 67 patients diagnosed in 1995 to 1996 were compared with 51 patients diagnosed in 1997 to 1998. To analyze factors associated with survival we used a Cox model including antiretroviral therapy as a time-dependent covariate. Results: Patients diagnosed in 1997 to 1998 were more likely to have TB asthe first AIDS-defining illness (78% versus 58%, p < .05), to have HIV diagnosed <2 months before TB (33% vs. 7%, p < .005) and to have typical chestradiograph pattern (45% vs. 25%,p < .05), and had a higher CD4(+) count (median 105 vs. 43, p < .005). Survival at 1 year was 80% for patients diagnosed in 1997 to 1998 vs. 65% for those diagnosed in 1995 to 1996 (p by log-rank = .02). After adjusting at multivariate analysis, time period of diagnosis was not confirmed as associated with survival (hazard ratio, 1.05; 95% confidence interval, 0.39-2.81). Age, CD4+ cell count < 25/mm(3), and AIDS-defining illnesses before TB diagnosis were all associated with an higher risk of death, whereas a decreased risk of death was observed in patients starting a triple combination antiretroviral therapy after TB diagnosis (hazard ratio, 0.14; 95% confidence interval, 0.03-0.57). Conclusions: Cases of HIV-associated TB occurring in patients with advanced immunosuppression and presenting with atypical radiologic appearance tendto be relatively less common in the HAART era. HAART is a major factor in prolonging survival in these patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/02/20 alle ore 22:46:35