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Rev Pneumol Clin. 2007 Jun;63(3):139-46.

[Mechanisms and causes of death in 143 Vietnamese HIV-infected patients hospitalized for tuberculosis].

[Article in French]

Author information

  • 1Pham Ngoc Thach Hospital, 120 Hung Vuong St, District 5, Ho Chi Minh City, Vietnam.

Abstract

OBJECTIVE OF THE STUDY:

To know the mechanisms and causes of death in Vietnamese VIH-infected patients hospitalized for tuberculosis.

METHODS:

Retrospective analysis of a monocentric cohort of 143 consecutive co infected patients admitted to Pham Ngoc Thach Hospital, in Ho Chi Minh City, between January 2004 and November 2004.

MAIN RESULTS:

All the patients were HIV-infected and AFB smear positive. The CD4 T lymphocyte count was 55/mm3 and the body mass index was 15.8 +/- 2 kg/m2. During the first three months after hospital admission and tuberculosis diagnosis, the percentage of deaths was 28.7% (41/143). The mechanisms of deaths were: progressive cachexia, acute respiratory failure, cardiogenic or bacteremic shock, coma and unexpected cardio respiratory arrest. The causes of death were tuberculosis (particularly mechanical complications such as compressive pneumothorax, pericarditis or pleuritis), metabolic disorders (mainly hyponatrémie and dyskaliema) and associated infection. In multivariate analysis, two parameters (available at admission) were predictive of short-term death: anemia (p=0.024) and hyponatrémie (p=0.026).

CONCLUSION:

The short term mortality of co infected patients with AIDS and tuberculosis remains high in developing countries. However, some causes of death such as compressive pneumothorax-pleuritis-pericarditis, metabolic disorder or even associated opportunistic infection i. e. pneumocystosis may be prevented or cured. Consequently, such patients must be carefully monitored and more particularly those with severe anemia and/or hyponatrémie at admission. Similarly appropriate diagnostic algorithms must be used in case of unfavorable evolution particularly to diagnose curable complication.

PMID:
17675937
[PubMed - indexed for MEDLINE]
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