Incidence of tuberculosis and survival after its diagnosis in patients infected with HIV-1 and HIV-2

Marianne A B van der Sande, Maarten F Schim van der Loeff, Rachel C Bennett, Mary Dowling, Akum A Aveika, Toyin O Togun, Saihou Sabally, David Jeffries, Richard A Adegbola, Ramu Sarge-Njie, Assan Jaye, Tumani Corrah, Samuel McConkey, Hilton C Whittle

Research output: Contribution to journalArticle

Abstract

BACKGROUND: In sub-Saharan Africa, tuberculosis (TB) is the most frequently diagnosed opportunistic infection and cause of death among HIV-infected patients. HIV-2 has been associated with less immune suppression, slower disease progression and longer survival.

OBJECTIVE: To examine whether the incidence of TB and survival after TB are associated with CD4 cell count rather than HIV type.

METHODS: Clinical and immunological data were retrospectively evaluated among an open clinic-based cohort of HIV-1- and HIV-2-infected patients to determine incidence of TB (first diagnosis > 28 days after HIV diagnosis) and subsequent mortality. Patients were grouped by CD4 cell count into those with < 200, 200-500 and > 500 x 10 cells/l.

RESULTS: Incident TB was diagnosed among 159 of 2012 patients, with 4973 person-years of observation time. In 105/159 (66.0%), the diagnosis was confirmed by direct microscopy or culture. Incidence of TB was highest in the group with < 200 x 10 cells/l (9.1/100 and 8.8/100 person-years in HIV-1 and HIV-2, respectively). Adjusted for CD4 cell count, there was no significant difference in incidence or mortality following TB between HIV-1- and HIV-2-infected patients. Mortality rate was higher in those with incident TB and HIV infection, most markedly in the group with the highest CD4 cell count (hazard ratio, 10.0; 95% confidence interval, 5.1-19.7).

CONCLUSION: Adjusted for CD4 cell count, incidence of TB was similar among HIV-1- and HIV-2-infected patients. Mortality rates after TB diagnosis were similar in both groups and high compared with those without TB.

Original languageEnglish
JournalAIDS
Volume18
Issue number14
Pages (from-to)1933-41
Number of pages9
ISSN0269-9370
DOIs
Publication statusPublished - 24-Sep-2004

Keywords

  • AIDS-Related Opportunistic Infections/complications
  • Adult
  • Africa South of the Sahara/epidemiology
  • CD4 Lymphocyte Count
  • Cohort Studies
  • Female
  • HIV-1
  • HIV-2
  • Humans
  • Incidence
  • Male
  • Prospective Studies
  • Retrospective Studies
  • Survival Analysis
  • Tuberculosis/complications

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