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Rev Epidemiol Sante Publique. 2017 Nov;65(6):419-426. doi: 10.1016/j.respe.2017.05.011. Epub 2017 Oct 22.

[Treatment outcome, survival and their risk factors among new tuberculosis patients co-infected with HIV during the Ebola outbreak in Conakry].

[Article in French]

Author information

1
Service de pneumo-phtisiologie, hôpital national Ignace Deen, CHU de Conakry, Conakry, Guinée; Chaire de santé publique, département de médecine, université de Conakry, Conakry, Guinée. Electronic address: aliounec@gmail.com.
2
Service des maladies infectieuses et tropicales, hôpital national Donka, CHU de Conakry, Conakry, Guinée.
3
Chaire de santé publique, département de pharmacie, université de Conakry, Conakry, Guinée.
4
Service de pneumo-phtisiologie, hôpital national Ignace Deen, CHU de Conakry, Conakry, Guinée.
5
Chaire de santé publique, département de médecine, université de Conakry, Conakry, Guinée.

Abstract

BACKGROUND:

Mortality among TB/HIV co-infected patients remains high in Africa. The study aimed to estimate survival and associated factors in a cohort of TB/HIV co-infected patients who started tuberculosis treatment during the Ebola outbreak in Conakry, Guinea.

METHODS:

A prospective cohort study was conducted from April 2014 to December 2015. TB patients with HIV co-infection were enrolled at the University Hospital of Conakry. Survival and risk factors were analyzed according to Kaplan-Meier's method, log-rank test and Cox's regression.

RESULTS:

Data from 573 patients were analyzed. From these, 86 (15.0%) died before the end of treatment, 52% occurring within eight weeks of treatment onset. Survival at 4, 12 and 24 weeks after the beginning of the TB treatment was 92%, 86% and 83%, respectively. Independent risk factors associated with death were in the cell CD4 <200 cells/mm3 [adjusted hazard ratio (AHR): 2.25; 95% CI (confidence intervals): 1.16-4.37], opportunistic infections other than TB [AHR: 2.89; 95% CI: 1.39-6.02], and comorbidities [AHR: 4.12; 95% CI: 2.10-8.10]. An increase of one unit in hemoglobin [AHR: 0.81; 95% CI: 0.75-0.91] was protective of death.

CONCLUSION:

TB/HIV co-infected patients had a higher fatality rate during treatment of tuberculosis. Prevention of opportunistic infections, anemia and proper management of tuberculosis treatment in early comorbidities may improve survival for TB/HIV co-infected patients in restoring immune function.

KEYWORDS:

Co-infection TB/VIH; Ebola; Facteurs de risque; Guinea; Guinée; Risk factors; Survie; Survival; TB/HIV co-infection

PMID:
29066256
DOI:
10.1016/j.respe.2017.05.011
[Indexed for MEDLINE]

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