HIV co-infection increases the risk of post-tuberculosis mortality among persons who initiated treatment for drug-resistant tuberculosis

Little is known regarding the relationship between common comorbidities in persons with tuberculosis (TB) (including human immunodeficiency virus [HIV], diabetes, and hepatitis C virus [HCV]) with post-TB mortality. We conducted a retrospective cohort study among persons who initiated treatment for rifampicin-resistant and multi/extensively drug-resistant (RR and M/XDR) TB reported to the country of Georgia's TB surveillance during 2009-2017. Exposures included HIV serologic status, diabetes, and HCV status. Our outcome was all-cause post-TB mortality determined by cross-validating vital status with Georgia's death registry through November 2019. We estimated adjusted hazard rate ratios (aHR) and 95% confidence intervals (CI) of post-TB mortality among participants with and without comorbidities using cause-specific hazard regressions. Among 1032 eligible participants, 34 (3.3%) died during treatment and 87 (8.7%) died post-TB treatment. Among those who died post-TB treatment, the median time to death was 21 months (interquartile range 7-39) post-TB treatment. After adjusting for confounders, the hazard rates of post-TB mortality were higher among participants with HIV co-infection (aHR=3.74, 95%CI 1.77-7.91) compared to those without HIV co-infection. In our cohort, post-TB mortality occurred most commonly in the first three years post-TB treatment. Linkage to care for common TB comorbidities post-treatment may reduce post-TB mortality rates.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

medRxiv : the preprint server for health sciences - (2024) vom: 26. März

Sprache:

Englisch

Beteiligte Personen:

Salindri, Argita D [VerfasserIn]
Kipiani, Maia [VerfasserIn]
Lomtadze, Nino [VerfasserIn]
Tukvadze, Nestani [VerfasserIn]
Avaliani, Zaza [VerfasserIn]
Blumberg, Henry M [VerfasserIn]
Masyn, Katherine E [VerfasserIn]
Rothenberg, Richard B [VerfasserIn]
Kempker, Russell R [VerfasserIn]
Magee, Matthew J [VerfasserIn]

Links:

Volltext

Themen:

Comorbidities
Diabetes
HIV co-infection
Hepatitis C
Post-TB mortality
Preprint
Tuberculosis

Anmerkungen:

Date Revised 25.04.2024

published: Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.1101/2023.05.19.23290190

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM357948114