Predictors of Mortality among Individuals with Tuberculosis and Human Immunodeficiency Virus Coinfection at a Reference Center in Southeastern Brazil: A Retrospective Cohort Study

    Published on:October 2018
    Journal of Young Pharmacists, 2018; 10(4):476-480
    Original Article | doi:10.5530/jyp.2018.10.103
    Authors:

    Dirce Ines Silva1,2*, Maria das Graças Braga Ceccato1,3, Michelline Rosa Silveira1,3, Silvana Spíndola Miranda4, Rosângela Maria Gomes1, João Paulo Amaral Haddad5, Wânia Silva Carvalho1,3

    1Postgraduate Program in Medicines and Pharmaceutical Assistance, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, MG, BRAZIL.

    2Hospital Foundation of the State of Minas Gerais/Eduardo de Menezes Hospital, Belo Horizonte, MG, BRAZIL.

    3Department of Social Pharmacy, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, MG, BRAZIL.

    4Department of Clinical Medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, BRAZIL.

    5Veterinary School of the Federal University of Minas Gerais – Department of Preventive Veterinary Medicine of the Federal University of Minas Gerais, Belo Horizonte, MG, BRAZIL.

    Abstract:

    Background: Tuberculosis (TB) remains an important cause of morbidity, the leading cause of death in patients with human immunodeficiency virus (HIV) infection, and a challenge to global public health. This study aimed to analyze the predictors associated with mortality among individuals coinfected with TB/HIV at a reference center in southeastern Brazil. Method: This retrospective cohort study used the data obtained from clinical records and information systems from 2007 to 2014. The data were analyzed using Cox proportional hazards model to identify the independent predictors. Results: Among the 924 individuals studied, 72.7 % were men. The median age was 38 years (range: 16–78 years). The mortality rate was 21.6%. The predictors associated with mortality were as follows: age over 50 years (Adjusted Hazard Ratio [AHR] : 2.52, 95% confidence interval [CI]: 1.39–4.59), CD4+ T lymphocyte count ≤200 cells/mm3 [AHR]: 1.40, 95% [CI]: 0.86–2.27), detectable viral load [AHR]: 1.73, 95% [CI]: 0.98–3.01), and non-use of antiretroviral therapy [AHR]: 2.91, 95% [CI]: 1.71–4.93). Conclusion: Results demonstrated that patients coinfected with TB/HIV have high mortality rates. Therefore, it is necessary to address the social determinants of health to provide every individual an equal opportunity to gain access to healthcare to cope with TB/HIV coinfection.

    Key words: Tuberculosis/HIV, Mortality, Retrospective cohort, Brazil.

    Article Download

     

    SCImago Journal & Country Rank

    Navigation