Research article
Risk and prognostic significance of tuberculosis in patients from The TREAT Asia HIV Observational Database
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* Corresponding author: Jialun Zhou jzhou@nchecr.unsw.edu.au
1 National Centre in HIV Epidemiology and Clinical Research The University of New South Wales, Sydney, Australia
2 Department of Medicine, Queen Elizabeth Hospital, Hong Kong, PR China
3 Tan Tock Seng Hospital, Singapore
4 Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
5 YRG Centre for AIDS Research and Education, Chennai, India
6 School of Medicine Udayana University & Sanglah Hospital, Denpasar, Bali, Indonesia
7 Institute of Infectious Diseases, Pune, India
8 Taipei Veterans General Hospital and AIDS Prevention and Research Centre, National Yang-Ming University, Taipei, Taiwan
9 HIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand
10 National Center for HIV/AIDS, Dermatology & STDs, Phnom Penh, Cambodia
11 Research Institute for Health Sciences, Chiang Mai, Thailand
12 Hospital Sungai Buloh, Kuala Lumpur, Malaysia
13 University of Malaya, Kuala Lumpur, Malaysia
14 International Medical Centre of Japan, Tokyo, Japan
15 Beijing Ditan Hospital, Beijing, PR China
16 Port Moresby General Hospital, Port Moresby, Papua New Guinea
17 Research Institute for Tropical Medicine, Manila, the Philippines
BMC Infectious Diseases 2009, 9:46 doi:10.1186/1471-2334-9-46
Published: 21 April 2009Abstract
Background
To assess the risk and the prognostic significance of tuberculosis (TB) diagnosis in patients from The TREAT Asia HIV Observational Database, a multi-centre prospective cohort of HIV-infected patients receiving HIV care in the Asia-Pacific region.
Methods
The risk of TB diagnosis after recruitment was assessed in patients with prospective follow-up. TB diagnosis was fitted as a time-dependent variable in assessing overall survival.
Results
At baseline, 22% of patients were diagnosed with TB. TB incidence was 1.98 per 100 person-years during follow up, with predictors including younger age, lower recent CD4 count, duration of antiretroviral treatment, and living in high TB burden countries. Among 3279 patients during 6968 person-years, 142 died (2.04 per 100 person-years). Compared to patients with CDC category A or B illness only, mortality was marginally higher in patients with single Non-TB AIDS defining illness (ADI), or TB only (adjusted HR 1.35, p = 0.173) and highest in patients with multiple non-TB AIDS or both TB and other ADI (adjusted HR 2.21, p < 0.001).
Conclusion
The risk of TB diagnosis was associated with increasing immunodeficiency and partly reduced by antiretroviral treatment. The prognosis of developing TB appeared to be similar to that following a diagnosis of other non-TB ADI.