Treatment outcome and mortality at one and half year follow-up of HIV infected TB patients under TB control programme in a district of South India.

<h4>Background</h4>There is paucity of data from India on the impact of HIV related immunosuppression in response to TB treatment and mortality among HIV infected TB patients. We assessed the TB treatment outcome and mortality in a cohort of HIV infected TB patients treated with intermit...

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Autores principales:	Sophia Vijay, Prahlad Kumar, Lakbir Singh Chauhan, Saroja Vadigepalli Narayan Rao, Preetish Vaidyanathan
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5480897c2d06477f9a0e5dccda931303
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spelling	oai:doaj.org-article:5480897c2d06477f9a0e5dccda9313032021-11-18T06:49:26ZTreatment outcome and mortality at one and half year follow-up of HIV infected TB patients under TB control programme in a district of South India.1932-620310.1371/journal.pone.0021008https://doaj.org/article/5480897c2d06477f9a0e5dccda9313032011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21814542/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>There is paucity of data from India on the impact of HIV related immunosuppression in response to TB treatment and mortality among HIV infected TB patients. We assessed the TB treatment outcome and mortality in a cohort of HIV infected TB patients treated with intermittent short course chemotherapy under TB control programme in a high HIV prevalent district of south India.<h4>Methodology/ findings</h4>Among 3798 TB patients registered for treatment in Mysore district from July 2007 to June 2008, 281 HIV infected patients formed the study group. The socio-demographic and treatment related data of these patients was obtained from TB and HIV programme records and patient interviews 19 months after TB treatment initiation by field investigators. Treatment success rate of 281 patients was 75% while in smear positive pulmonary tuberculosis cases it was 62%, attributable to defaults (16%) and deaths (19%). Only 2 patients had treatment failure. Overall, 83 (30%) patients were reported dead; 26 while on treatment and 57 after TB treatment. Association of treatment related factors with treatment outcome and survival status was studied through logistic regression analysis. Factors significantly associated with 'unfavourable outcome' were disease classification as Pulmonary [aOR-1.96, CI (1.02-3.77)], type of patient as retreatment [aOR-4.78, CI (2.12-10.76)], and non initiation of ART [aOR-4.90, CI (1.85-12.96)]. Factors associated with 'Death' were non initiation of ART [aOR-2.80, CI (1.15-6.81)] and CPT [aOR-3.46, CI (1.47-8.14)].<h4>Conclusion</h4>Despite the treatment success of 75% the high mortality (30%) in the study group is a matter of concern and needs immediate intervention. Non initiation of ART has emerged as a high risk factor for unfavourable treatment outcome and mortality. These findings underscore the importance of expanding and improving delivery of ART services as a priority and reconsideration of the programme guidelines for ART initiation in HIV infected TB patients.Sophia VijayPrahlad KumarLakbir Singh ChauhanSaroja Vadigepalli Narayan RaoPreetish VaidyanathanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 7, p e21008 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sophia Vijay Prahlad Kumar Lakbir Singh Chauhan Saroja Vadigepalli Narayan Rao Preetish Vaidyanathan Treatment outcome and mortality at one and half year follow-up of HIV infected TB patients under TB control programme in a district of South India.
description	<h4>Background</h4>There is paucity of data from India on the impact of HIV related immunosuppression in response to TB treatment and mortality among HIV infected TB patients. We assessed the TB treatment outcome and mortality in a cohort of HIV infected TB patients treated with intermittent short course chemotherapy under TB control programme in a high HIV prevalent district of south India.<h4>Methodology/ findings</h4>Among 3798 TB patients registered for treatment in Mysore district from July 2007 to June 2008, 281 HIV infected patients formed the study group. The socio-demographic and treatment related data of these patients was obtained from TB and HIV programme records and patient interviews 19 months after TB treatment initiation by field investigators. Treatment success rate of 281 patients was 75% while in smear positive pulmonary tuberculosis cases it was 62%, attributable to defaults (16%) and deaths (19%). Only 2 patients had treatment failure. Overall, 83 (30%) patients were reported dead; 26 while on treatment and 57 after TB treatment. Association of treatment related factors with treatment outcome and survival status was studied through logistic regression analysis. Factors significantly associated with 'unfavourable outcome' were disease classification as Pulmonary [aOR-1.96, CI (1.02-3.77)], type of patient as retreatment [aOR-4.78, CI (2.12-10.76)], and non initiation of ART [aOR-4.90, CI (1.85-12.96)]. Factors associated with 'Death' were non initiation of ART [aOR-2.80, CI (1.15-6.81)] and CPT [aOR-3.46, CI (1.47-8.14)].<h4>Conclusion</h4>Despite the treatment success of 75% the high mortality (30%) in the study group is a matter of concern and needs immediate intervention. Non initiation of ART has emerged as a high risk factor for unfavourable treatment outcome and mortality. These findings underscore the importance of expanding and improving delivery of ART services as a priority and reconsideration of the programme guidelines for ART initiation in HIV infected TB patients.
format	article
author	Sophia Vijay Prahlad Kumar Lakbir Singh Chauhan Saroja Vadigepalli Narayan Rao Preetish Vaidyanathan
author_facet	Sophia Vijay Prahlad Kumar Lakbir Singh Chauhan Saroja Vadigepalli Narayan Rao Preetish Vaidyanathan
author_sort	Sophia Vijay
title	Treatment outcome and mortality at one and half year follow-up of HIV infected TB patients under TB control programme in a district of South India.
title_short	Treatment outcome and mortality at one and half year follow-up of HIV infected TB patients under TB control programme in a district of South India.
title_full	Treatment outcome and mortality at one and half year follow-up of HIV infected TB patients under TB control programme in a district of South India.
title_fullStr	Treatment outcome and mortality at one and half year follow-up of HIV infected TB patients under TB control programme in a district of South India.
title_full_unstemmed	Treatment outcome and mortality at one and half year follow-up of HIV infected TB patients under TB control programme in a district of South India.
title_sort	treatment outcome and mortality at one and half year follow-up of hiv infected tb patients under tb control programme in a district of south india.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/5480897c2d06477f9a0e5dccda931303
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Treatment outcome and mortality at one and half year follow-up of HIV infected TB patients under TB control programme in a district of South India.

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