A prospective study of tuberculosis and HIV disease progression

Sonal S. Munsiff, Peter L. Alpert, Marc N. Gourevitch, C. J. Chang, Robert S. Klein

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Objective: To determine whether active tuberculosis alters the rate of progression of HIV infection in dually infected patients. Methods: HIV- seropositive patients at two Bronx, New York hospitals with tuberculosis confirmed by culture from July 1992 to February 1995, who survived the initial hospitalization for tuberculosis, were matched on gender, age, CD4+ percentage, and calendar time with HIV-seropositive patients without tuberculosis participating in a study of the natural history of HIV infection. Patients received follow-up observation prospectively until May 23, 1995 to determine survival rates and development of AIDS-defining opportunistic infections (OIs). Results: 70 patients had tuberculosis; 120 did not. Mean CD4+ percentages were 12.4% and 12.5%, respectively. At study entry, 27% of those with tuberculosis had prior AIDS-defining OIs other than tuberculosis, compared with 10% of those without tuberculosis (p = .004). In multivariate survival analysis, controlling for CD4+ level, tuberculosis was not an independent predictor of increased other causes of AIDS-related mortality. However, in a logistic regression model, independent predictors of subsequent OIs included tuberculosis (hazard ratio, 4.1; 95% confidence intervals [CI], 1.9, 8.7), CD4+ count <100/mm3 (hazard ratio, 2.4; 95% CI, 1.1, 5.0) and prior OIs (hazard ration, 3.3; 95% CI, 1.3, 8.3). Conclusions: Tuberculosis was not an independent predictor of increased nontuberculosis- related mortality in HIV-seropositive patients but was associated with increased risk of development of OIs.

Original languageEnglish (US)
Pages (from-to)361-366
Number of pages6
JournalJournal of Acquired Immune Deficiency Syndromes and Human Retrovirology
Volume19
Issue number4
StatePublished - Dec 1 1998

Fingerprint

Disease Progression
Tuberculosis
HIV
Prospective Studies
Opportunistic Infections
Acquired Immunodeficiency Syndrome
Confidence Intervals
HIV Infections
Logistic Models
Chronic Disease Hospitals
Mortality
CD4 Lymphocyte Count
Survival Analysis
Hospitalization
Multivariate Analysis
Survival Rate
Observation

Keywords

  • HIV
  • Natural history
  • Survival
  • Tuberculosis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Virology

Cite this

A prospective study of tuberculosis and HIV disease progression. / Munsiff, Sonal S.; Alpert, Peter L.; Gourevitch, Marc N.; Chang, C. J.; Klein, Robert S.

In: Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, Vol. 19, No. 4, 01.12.1998, p. 361-366.

Research output: Contribution to journalArticle

Munsiff, Sonal S. ; Alpert, Peter L. ; Gourevitch, Marc N. ; Chang, C. J. ; Klein, Robert S. / A prospective study of tuberculosis and HIV disease progression. In: Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology. 1998 ; Vol. 19, No. 4. pp. 361-366.
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