Predictors of survival in HIV-infected tuberculosis patients

AIDS. 1996 Mar;10(3):269-72. doi: 10.1097/00002030-199603000-00005.

Abstract

Objective: To ascertain predictors of survival in HIV-infected tuberculosis (TB) patients.

Design: Retrospective cohort study.

Setting: New York City public hospital.

Patients: Fifty-four consecutive HIV-seropositive patients with newly diagnosed TB and no other AIDS-defining illnesses.

Main outcome measures: CD4+ T-lymphocyte counts, completion of anti-TB therapy, repeat hospitalizations with TB, and survival.

Results: Forty-five (84%) of the 54 patients died a median of 15 months after TB diagnosis (range, 1-80 months), five (9%) were alive after a median of 81 months (range, 75-84 months), and four (7%) were lost to follow-up after a median of 42 months (range, 30-66 months). In univariate analyses, disseminated TB, intrathoracic adenopathy, oral candidiasis and CD4 count depletion were each associated with decreased survival. In a multivariate analysis, CD4 count depletion was the only independent predictor of decreased survival. Repeat hospitalization with TB occurred in 10 out of 15 patients who did not complete anti-TB therapy compared with one out of 21 patients who completed anti-TB therapy (P < 0.001).

Conclusion: The clinical presentation of TB and CD4 count at TB diagnosis are each predictive of survival in HIV-seropositive TB patients. The CD4 count is the only independent predictor of survival.

MeSH terms

  • Adult
  • CD4 Lymphocyte Count
  • Cohort Studies
  • Female
  • HIV Infections / complications
  • HIV Infections / epidemiology
  • HIV Infections / mortality*
  • Humans
  • Male
  • New York City / epidemiology
  • Patient Compliance
  • Retrospective Studies
  • Survival Analysis*
  • Treatment Failure
  • Tuberculosis / complications
  • Tuberculosis / epidemiology
  • Tuberculosis / mortality*