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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Prevalence, incidence and mortality associated with tuberculosis in HIV-infected patients initiating antiretroviral therapy in rural Uganda
AIDS, Volume 21, No. 6, Year 2007
Notification
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Description
BACKGROUND: Tuberculosis (TB) is the leading cause of death among people with HIV in sub-Saharan Africa. Expanding access to antiretroviral therapy (ART) may reduce the burden of TB, but to what extent is unknown. METHODS: In a study of 1044 adults who initiated home-based ART in Tororo, Uganda between 1 May 2003 and 30 June 2005, participants were screened for active TB at baseline and then monitored at weekly home visits. Participants with TB at baseline or follow-up were compared with those without TB to determine factors associated with mortality in those with TB. RESULTS: At baseline, 75 (7.2%) subjects had TB and a total of 53 (5.5%) were diagnosed with TB over a median of 1.4 years of follow-up (3.90 cases/100 person years). Cumulative mortality was 17.9/100 person-years for those with TB and 3.8/100 person-years for those without TB (P < 0.001). Mortality was associated with low baseline CD4 cell counts [relative hazard (RH), 0.99 per 1 cell/μl increase; P = 0.03] and marginally associated with a body mass index ≤ 18 (RH, 2.04; P = 0.10) and increasing age (RH, 1.04 per year; P = 0.11). TB incidence and TB-associated mortality were highest within the first 6 months of ART and declined to 52% and 61% of expected values, respectively, from months 7 to 18 after ART initiation. CONCLUSION: TB remains an important cause of illness and death in patients receiving ART in Uganda. However, both appear to decline markedly, after 6 months of ART. © 2007 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Moore, David M.
United States, Atlanta
Centers for Disease Control and Prevention
Canada, Vancouver
British Columbia Centre for Excellence in Hiv-aids
Canada, Vancouver
The University of British Columbia
Uganda, Entebbe
Uganda Virus Research Institute
Liechty, Cheryl A.
United States, Atlanta
Centers for Disease Control and Prevention
United States, San Francisco
University of California, San Francisco
Ekwaru, John Paul
United States, Atlanta
Centers for Disease Control and Prevention
Were, Willy A.
United States, Atlanta
Centers for Disease Control and Prevention
Mwima, Gerald
United States, Atlanta
Centers for Disease Control and Prevention
Solberg, Peter
United States, Atlanta
Centers for Disease Control and Prevention
United States, San Francisco
University of California, San Francisco
Rutherford, George Williams
United States, San Francisco
University of California, San Francisco
Mermin, Jonathan H.
United States, Atlanta
Centers for Disease Control and Prevention
Statistics
Citations: 223
Authors: 8
Affiliations: 5
Identifiers
Doi:
10.1097/QAD.0b013e328013f632
Research Areas
Environmental
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Uganda