Impact of tuberculosis on mortality among HIV-infected patients receiving antiretroviral therapy in Uganda: a prospective cohort analysis

详细信息    查看全文

• 作者：Rong Chu (1) (2)
  Edward J Mills (1) (3)
  Joseph Beyene (1)
  Eleanor Pullenayegum (1) (2)
  Celestin Bakanda (4)
  Jean B Nachega (5) (6)
  P J Devereaux (1) (7)
  Lehana Thabane (1) (2)
  
• 关键词：Antiretroviral therapy ; HIV ; Tuberculosis ; Propensity score methods ; Uganda ; Prospective cohort study
• 刊名：AIDS Research and Therapy
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：10
• 期：1
• 全文大小：240KB
• 参考文献：1. World Health Organization: / Global summary of the HIV/AIDS epidemic. 2009. [http://www.who.int/hiv/data/2009_global_summary.gif] Accessed July 16, 2012
  2. Selwyn PA, Hartel D, Lewis VA, Schoenbaum EE, Vermund SH, Klein RS, Walker AT, Friedland GH: A prospective study of the risk of tuberculosis among intravenous drug users with human immunodeficiency virus infection. / N Engl J Med 1989,320(9):545-50. CrossRef
  3. / Centers for Disease Control and Prevention. TB and HIV/AIDS. CDC HIV/AIDS facts. 2012. [http://www.cdc.gov/hiv/resources/factsheets/PDF/hivtb.pdf] Accessed July 16, 2012
  4. Abdool Karim SS, Naidoo K, Grobler A, Padayatchi N, Baxter C, Gray A, Gengiah T, Nair G, Bamber S, Singh A, Khan M, Pienaar J, El-Sadr W, Friedland G, Abdool Karim Q: Timing of initiation of antiretroviral drugs during tuberculosis therapy. / N Engl J Med 2010,362(8):697-06. CrossRef
  5. Blanc FX, Sok T, Laureillard D, Borand L, Rekacewicz C, Nerrienet E, Madec Y, Marcy O, Chan S, Prak N, Kim C, Lak KK, Hak C, Dim B, Sin CI, Sun S, Guillard B, Sar B, Vong S, Fernandez M, Fox L, Delfraissy JF, Goldfeld AE, CAMELIA (ANRS 1295-CIPRA KH001) Study Team: Earlier versus later start of antiretroviral therapy in HIV-infected adults with tuberculosis. / N Engl J Med 2011,365(16):1471-481. CrossRef
  6. Havlir DV, Kendall MA, Ive P, Kumwenda J, Swindells S, Qasba SS, Luetkemeyer AF, Hogg E, Rooney JF, Wu X, Hosseinipour MC, Lalloo U, Veloso VG, Some FF, Kumarasamy N, Padayatchi N, Santos BR, Reid S, Hakim J, Mohapi L, Mugyenyi P, Sanchez J, Lama JR, Pape JW, Sanchez A, Asmelash A, Moko E, Sawe F, Andersen J, Sanne I, AIDS Clinical Trials Group Study A5221: Timing of antiretroviral therapy for HIV-1 infection and tuberculosis. / N Engl J Med 2011,365(16):1482-491. CrossRef
  7. World Health Organization: / Joint HIV/Tuberculosis interventions. 2012. [http://www.who.int/hiv/topics/tb/tuberculosis/en/] Accessed July 16, 2012
  8. Marks S, Magee E, Robison V: Reported HIV status of tuberculosis patients—United States, 1993-005. / MMWR Morb Mortal Wkly Rep 2007,56(42):1103-106.
  9. Harries AD, Zachariah R, Corbett EL, Lawn SD, Santos-Filho ET, Chimzizi R, Harrington M, Maher D, Williams BG, De Cock KM: The HIV-associated tuberculosis epidemic–when will we act? / Lancet 2010,375(9729):1906-919. CrossRef
  10. Burman WJ, Jones BE: Treatment of HIV-related tuberculosis in the era of effective antiretroviral therapy. / Am J Respir Crit Care Med 2001,164(1):7-2. CrossRef
  11. Narita M, Ashkin D, Hollender ES, Pitchenik AE: Paradoxical worsening of tuberculosis following antiretroviral therapy in patients with AIDS. / Am J Respir Crit Care Med 1998,158(1):157-61. CrossRef
  12. McIlleron H, Meintjes G, Burman WJ, Maartens G: Complications of antiretroviral therapy in patients with tuberculosis: drug interactions, toxicity, and immune reconstitution inflammatory syndrome. / J Infect Dis 2007,196(Suppl 1):S63-S75. CrossRef
  13. Gandhi NR, Nunn P, Dheda K, Schaaf HS, Zignol M, van Soolingen D, Jensen P, Bayona J: Multidrug-resistant and extensively drug-resistant tuberculosis: a threat to global control of tuberculosis. / Lancet 2010,375(9728):1830-843. CrossRef
  14. Lonnroth K, Castro KG, Chakaya JM, Chauhan LS, Floyd K, Glaziou P, Raviglione MC: Tuberculosis control and elimination 2010-0: cure, care, and social development. / Lancet 2010,375(9728):1814-829. CrossRef
  15. Moore D, Liechty C, Ekwaru P, Were W, Mwima G, Solberg P, Rutherford G, Mermin J: Prevalence, incidence and mortality associated with tuberculosis in HIV-infected patients initiating antiretroviral therapy in rural Uganda. / AIDS 2007,21(6):713-19. CrossRef
  16. Westreich D, MacPhail P, Van Rie A, Malope-Kgokong B, Ive P, Rubel D, Boulme R, Eron J, Sanne I: Effect of pulmonary tuberculosis on mortality in patients receiving HAART. / AIDS 2009,23(6):707-15. CrossRef
  17. Lopez-Gatell H, Cole SR, Hessol NA, French AL, Greenblatt RM, Landesman S, Preston-Martin S, Anastos K: Effect of tuberculosis on the survival of women infected with human immunodeficiency virus. / Am J Epidemiol 2007,165(10):1134-142. CrossRef
  18. Lopez-Gatell H, Cole SR, Margolick JB, Witt MD, Martinson J, Phair JP, Jacobson LP, Multicenter AIDS Cohort Study: Effect of tuberculosis on the survival of HIV-infected men in a country with low tuberculosis incidence. / AIDS 2008,22(14):1869-873. CrossRef
  19. Straetemans M, Bierrenbach AL, Nagelkerke N, Glaziou P, van der Werf MJ: The effect of tuberculosis on mortality in HIV positive people: a meta-analysis. / PLoS One 2010,5(12):e15241. CrossRef
  20. Rosenbaum PR, Rubin DB: The central role of the propensity score in observational studies for causal effects. / Biometrika 1983,70(1):41-5. CrossRef
  21. Rosenbaum PR, Rubin DB: Reducing bias in observational studies using subclassification on the propensity score. / J Am Stat Assoc 1984, 79:516-24. CrossRef
  22. Rubin DB: The design versus the analysis of observational studies for causal effects: parallels with the design of randomized trials. / Stat Med 2007,26(1):20-6. CrossRef
  23. Bakanda C, Birungi J, Nkoyooyo A, Featherstone A, Cooper CL, Hogg RS, Mills EJ: Cohort Profile: The TASO-CAN Cohort Collaboration. / Int J Epidemiol 2012,41(4):946-50. http://ije.oxfordjournals.org/content/41/4/946 CrossRef
  24. Ministry of health: / National Antiretroviral Treatment and Care Guidelines for Adults and Children: Kampala. Uganda: Earnest Publishers; 2008.
  25. Druyts E, Dybul M, Kanters S, Nachega J, Birungi J, Ford N, Thorlund K, Negin J, Lester R, Yaya S, Mills EJ: Male sex and the risk of mortality among individuals enrolled in antiretroviral therapy programs in Africa: a systematic review and meta-analysis. / AIDS 2013,27(3):417-25. CrossRef
  26. / AIDS Basics. 2013. [http://aids.gov/hiv-aids-basics/] Accessed June 22, 2013
  27. Vlahov D, Graham N, Hoover D, Flynn C, Bartlett JG, Margolick JB, Lyles CM, Nelson KE, Smith D, Holmberg S, Farzadegan H: Prognostic indicators for AIDS and infectious disease death in HIV-infected injection drug users: plasma viral load and CD4+ cell count. / JAMA 1998,279(1):35-0. CrossRef
  28. May M, Sterne JA, Sabin C, Costagliola D, Justice AC, Thiebaut R, Gill J, Phillips A, Reiss P, Hogg R, Ledergerber B, D’Arminio Monforte A, Schmeisser N, Staszewski S, Egger M, Antiretroviral Therapy (ART) Cohort Collaboration: Prognosis of HIV-1-infected patients up to 5 years after initiation of HAART: collaborative analysis of prospective studies. / AIDS 2007,21(9):1185-197. CrossRef
  29. Dheda K, Shean K, Zumla A, Badri M, Streicher EM, Page-Shipp L, Willcox P, John MA, Reubenson G, Govindasamy D, Wong M, Padanilam X, Dziwiecki A, van Helden PD, Siwendu S, Jarand J, Menezes CN, Burns A, Victor T, Warren R, Grobusch MP, van der Walt M, Kvasnovsky C: Early treatment outcomes and HIV status of patients with extensively drug-resistant tuberculosis in South Africa: a retrospective cohort study. / Lancet 2010,375(9728):1798-807. CrossRef
  30. Bakanda C, Birungi J, Mwesigwa R, Zhang W, Hagopian A, Ford N, Mills EJ: Density of healthcare providers and patient outcomes: evidence from a nationally representative multi-site HIV treatment program in Uganda. / PLoS One 2011,6(1):e16279. CrossRef
  31. Mills EJ, Beyrer C, Birungi J, Dybul MR: Engaging men in prevention and care for HIV/AIDS in Africa. / PLoS Med 2012,9(2):e1001167. CrossRef
  32. Epstein H, Swidler A, Gray R, Reniers G, Parker W, Parkhurst J, Short R, Halperin D: Measuring concurrent partnerships. / Lancet 2010,375(9729):1869. author reply 1870 CrossRef
  33. Eyawo O, de Walque D, Ford N, Gakii G, Lester RT, Mills EJ: HIV status in discordant couples in sub-Saharan Africa: a systematic review and meta-analysis. / Lancet Infect Dis 2010,10(11):770-77. CrossRef
  34. Padian NS, Manian S: The concurrency debate: time to put it to rest. / Lancet 2011,378(9787):203-04. CrossRef
  35. Centers for Disease Control and Prevention: / Basic TB Facts. 2013. [http://www.cdc.gov/tb/topic/basics/risk.htm] Accessed June 22, 2013
  36. Austin PC: A critical appraisal of propensity-score matching in the medical literature between 1996 and 2003. / Stat Med 2008,27(12):2037-049. CrossRef
  37. Gayat E, Pirracchio R, Resche-Rigon M, Mebazaa A, Mary JY, Porcher R: Propensity scores in intensive care and anaesthesiology literature: a systematic review. / Intensive Care Med 2010,36(12):1993-003. CrossRef
  38. Tleyjeh IM, Kashour T, Zimmerman V, Steckelberg JM, Wilson WR, Baddour LM: The role of valve surgery in infective endocarditis management: a systematic review of observational studies that included propensity score analysis. / Am Heart J 2008,156(5):901-09. CrossRef
  39. Guo S, Fraser MW: / Propensity Score Analysis: Statistical Methods and Applications. Thousand Oaks, CA: SAGE Publications, Inc.; 2010.
  40. Austin PC: Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples. / Stat Med 2009,28(25):3083-107. CrossRef
  41. Austin PC: A Tutorial and Case Study in Propensity Score Analysis: An Application to Estimating the Effect of In-Hospital Smoking Cessation Counseling on Mortality. / Multivariate Behav Res 2011,46(1):119-51. CrossRef
  42. Austin PC: An Introduction to Propensity Score Methods for Reducing the Effects of Confounding in Observational Studies. / Multivariate Behav Res 2011,46(3):399-24. CrossRef
  43. Cohen J: / Statistical power analysis for the behavioural sciences: 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates Publishers; 1988.
  44. Ho DE: Using propensity scores to help design observational studies: application to the tobacco litigation. / Health sciences and outcomes research methodology 2001, 2:169-88. CrossRef
  45. Austin PC, Mamdani MM: A comparison of propensity score methods: a case-study estimating the effectiveness of post-AMI statin use. / Stat Med 2006,25(12):2084-106. CrossRef
  46. Coca-Perraillon M: / Local and global optimal propensity score matching. Orlando, Florida: Proceedings of the SAS Global Forum 2007; 2007.
  47. Austin PC: Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies. / Pharm Stat 2011,10(2):150-61. CrossRef
  48. Cummings P, McKnight B, Greenland S: Matched cohort methods for injury research. / Epidemiol Rev 2003, 25:43-0. CrossRef
  49. Little RJA, Rubin DB: / Statistical Analysis with Missing Data: 2nd ed. New Jersey: John Wiley & Sons, Inc.; 2002.
  50. Abaasa AM, Todd J, Ekoru K, Kalyango JN, Levin J, Odeke E, Karamagi CA: Good adherence to HAART and improved survival in a community HIV/AIDS treatment and care programme: the experience of The AIDS Support Organization (TASO), Kampala, Uganda. / BMC Health Serv Res 2008, 8:241-963--241. CrossRef
  51. Kiboneka A, Nyatia RJ, Nabiryo C, Anema A, Cooper CL, Fernandes KA, Montaner JS, Mills EJ: Combination antiretroviral therapy in population affected by conflict: outcomes from large cohort in northern Uganda. / BMJ 2009, 338:b201. CrossRef
  52. Morroni C, Chaisson R, Goliath R, / et al.: / Influence of IRIS on ART adherence in HIV-?adults. South Africa: CROI; 2012. Abstract# 941
  53. Gandhi NR, Moll A, Sturm AW, Pawinski R, Govender T, Lalloo U, Zeller K, Andrews J, Friedland G: Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa. / Lancet 2006,368(9547):1575-580. CrossRef
  54. Stukel TA, Fisher ES, Wennberg DE, Alter DA, Gottlieb DJ, Vermeulen MJ: Analysis of observational studies in the presence of treatment selection bias: effects of invasive cardiac management on AMI survival using propensity score and instrumental variable methods. / JAMA 2007,297(3):278-85. CrossRef
  55. World Health Organization: / Treatment of tuberculosis: guidelines for national programmes: 3rd ed. Geneva, Switzerland: World Health Organization; 2003.
  
• 作者单位：Rong Chu (1) (2)
  Edward J Mills (1) (3)
  Joseph Beyene (1)
  Eleanor Pullenayegum (1) (2)
  Celestin Bakanda (4)
  Jean B Nachega (5) (6)
  P J Devereaux (1) (7)
  Lehana Thabane (1) (2)
  
  1. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
  2. Biostatistics Unit, St Joseph’s Healthcare Hamilton, 3rd Floor Martha, Room H325, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada
  3. Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
  4. The AIDS Support Organization (TASO), Kampala, Uganda
  5. Department of Medicine and Centre for Infectious Diseases, Stellenbosch University, Cape Town, South Africa
  6. Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
  7. Hamilton Health Sciences, Population Health Research Institute, Hamilton, Canada
  
• ISSN：1742-6405

文摘

Background Tuberculosis (TB) disease affects survival among HIV co-infected patients on antiretroviral therapy (ART). Yet, the magnitude of TB disease on mortality is poorly understood. Methods Using a prospective cohort of 22,477 adult patients who initiated ART between August 2000 and June 2009 in Uganda, we assessed the effect of active pulmonary TB disease at the initiation of ART on all-cause mortality using a Cox proportional hazards model. Propensity score (PS) matching was used to control for potential confounding. Stratification and covariate adjustment for PS and not PS-based multivariable Cox models were also performed. Results A total of 1,609 (7.52%) patients had active pulmonary TB at the start of ART. TB patients had higher proportions of being male, suffering from AIDS-defining illnesses, having World Health Organization (WHO) disease stage III or IV, and having lower CD4 cell counts at baseline (p-lt;-.001). The percentages of death during follow-up were 10.47% and 6.38% for patients with and without TB, respectively. The hazard ratio (HR) for mortality comparing TB to non-TB patients using 1,686 PS-matched pairs was 1.37 (95% confidence interval [CI]: 1.08 -1.75), less marked than the crude estimate (HR--.74, 95% CI: 1.49 -2.04). The other PS-based methods and not PS-based multivariable Cox model produced similar results. Conclusions After controlling for important confounding variables, HIV patients who had TB at the initiation of ART in Uganda had an approximate 37% increased hazard of overall mortality relative to non-TB patients.