Effect of tuberculosis on the survival of women infected with human immunodeficiency virus

H. López-Gatell, S. R. Cole, N. A. Hessol, A. L. French, R. M. Greenblatt, S. Landesman, S. Preston-Martin, Kathryn Anastos

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Evidence regarding the effect of tuberculosis (TB) disease on progression of human immunodeficiency virus (HIV) disease is inconclusive. The authors estimated the effect of time-varying incident TB on time to acquired immunodeficiency syndrome (AIDS)-related mortality using a joint marginal structural Cox model. Between 1995 and 2002, 1,412 HIV type 1 (HIV-1)-infected women enrolled in the Women's Interagency HIV Study were followed for a median of 6 years. Twenty-nine women incurred incident TB, and 222 died of AIDS-related causes. Accounting for age, CD4 cell count, HIV-1 RNA level, serum albumin level, and non-TB AIDS at study entry, as well as for time-varying CD4 cell count, CD4 cell count nadir, HIV-1 RNA level, peak HIV-1 RNA level, serum albumin level, HIV-related symptoms, non-TB AIDS, anti-Pneumocystis jiroveci prophylaxis, antiretroviral therapy, and household income, the hazard ratio for AIDS-related death comparing time after incident TB with time before incident TB was 4.0 (95% confidence interval (CI): 1.2, 14). The effect of incident TB on mortality was similar among highly active antiretroviral therapy (HAART)-exposed women (hazard ratio = 4.3, 95% CI: 0.9, 22) and non-HAART-exposed women (hazard ratio = 3.9, 95% CI: 0.9, 17; interaction p = 0.91). Although results were imprecise because few women incurred TB, irrespective of HAART exposure, incident TB increases the hazard of AIDS-related death among HIV-infected women.

Original languageEnglish (US)
Pages (from-to)1134-1142
Number of pages9
JournalAmerican Journal of Epidemiology
Volume165
Issue number10
DOIs
StatePublished - May 2007
Externally publishedYes

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Tuberculosis
HIV
Acquired Immunodeficiency Syndrome
Survival
HIV-1
CD4 Lymphocyte Count
Highly Active Antiretroviral Therapy
RNA
Confidence Intervals
Serum Albumin
Pneumocystis carinii
Mortality
Structural Models
Virus Diseases
Proportional Hazards Models
Disease Progression
Joints
Therapeutics

Keywords

  • Acquired immunodeficiency syndrome
  • Causality
  • Disease progression
  • HIV infections
  • Models, statistical
  • Survival analysis
  • Tuberculosis
  • Women

ASJC Scopus subject areas

  • Epidemiology

Cite this

López-Gatell, H., Cole, S. R., Hessol, N. A., French, A. L., Greenblatt, R. M., Landesman, S., ... Anastos, K. (2007). Effect of tuberculosis on the survival of women infected with human immunodeficiency virus. American Journal of Epidemiology, 165(10), 1134-1142. https://doi.org/10.1093/aje/kwk116

Effect of tuberculosis on the survival of women infected with human immunodeficiency virus. / López-Gatell, H.; Cole, S. R.; Hessol, N. A.; French, A. L.; Greenblatt, R. M.; Landesman, S.; Preston-Martin, S.; Anastos, Kathryn.

In: American Journal of Epidemiology, Vol. 165, No. 10, 05.2007, p. 1134-1142.

Research output: Contribution to journalArticle

López-Gatell, H, Cole, SR, Hessol, NA, French, AL, Greenblatt, RM, Landesman, S, Preston-Martin, S & Anastos, K 2007, 'Effect of tuberculosis on the survival of women infected with human immunodeficiency virus', American Journal of Epidemiology, vol. 165, no. 10, pp. 1134-1142. https://doi.org/10.1093/aje/kwk116
López-Gatell H, Cole SR, Hessol NA, French AL, Greenblatt RM, Landesman S et al. Effect of tuberculosis on the survival of women infected with human immunodeficiency virus. American Journal of Epidemiology. 2007 May;165(10):1134-1142. https://doi.org/10.1093/aje/kwk116
López-Gatell, H. ; Cole, S. R. ; Hessol, N. A. ; French, A. L. ; Greenblatt, R. M. ; Landesman, S. ; Preston-Martin, S. ; Anastos, Kathryn. / Effect of tuberculosis on the survival of women infected with human immunodeficiency virus. In: American Journal of Epidemiology. 2007 ; Vol. 165, No. 10. pp. 1134-1142.
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