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J Acquir Immune Defic Syndr. 2006 Sep;43(1):42-6.

Survival rate and risk factors of mortality among HIV/tuberculosis-coinfected patients with and without antiretroviral therapy.

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Bamrasnaradura Infectious Diseases Institute, Ministry of Public Health, Nonthaburi and Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.



The impact of antiretroviral therapy (ART) on survival among patients coinfected with HIV and tuberculosis (TB) has not been well established.


A retrospective cohort study was conducted among HIV-infected patients with TB between January 2000 and December 2004. Patients were categorized into ART+ group (received ART) and ART- group (did not receive ART) and were followed until April 2005.


A total of 1003 patients were identified; 411 in ART+ group and 592 in ART- group. Median (interquartile range) CD4 count was 53 (20-129) cells/mm3. Survival rates at 1, 2, and 3 years after TB diagnosis were 96.1%, 94.0%, and 87.7% for ART+ group and 44.4%, 19.2%, and 9.3% for ART- group (log-rank test, P<0.001). Cox proportional hazard model showed that ART was associated with lower mortality rate; gastrointestinal TB and multidrug resistant TB were associated with higher mortality rate (P<0.05). Among patients in ART+ group, the patients who delayed ART>or=6 months after TB diagnosis had a higher mortality rate than those who initiated ART<6 months after TB diagnosis (P 0.018, hazard ratio=2.651, 95% confidence interval=1.152-6.102).


Antiretroviral therapy substantially reduces mortality rate among HIV/TB-coinfected patients. Initiation of ART within 6 months of TB diagnosis is associated with greater survival.

[Indexed for MEDLINE]

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