One-year mortality of HIV-positive patients treated for rifampicin- and isoniazid-susceptible tuberculosis in Eastern Europe, Western Europe, and Latin America

DN Podlekareva; A Schultze; A Panteleev; AM Skrahina; JM Miro; A Rakhmanova; H Furrer; RF Miller; AMW Efsen; MH Losso; J Toibaro; A. Vassilenko; E Girardi; JD Lundgren; A Mocroft; FA Post; O Kirk; TB:HIV Study writing Group

doi:10.1097/QAD.0000000000001333

One-year mortality of HIV-positive patients treated for rifampicin- and isoniazid-susceptible tuberculosis in Eastern Europe, Western Europe, and Latin America

DN Podlekareva, A Schultze, A Panteleev, AM Skrahina, JM Miro, A Rakhmanova, H Furrer, RF Miller, AMW Efsen, MH Losso, J Toibaro, A. Vassilenko, E Girardi, JD Lundgren, A Mocroft, FA Post, O Kirk, TB:HIV Study writing Group

Department of Clinical Medicine

5 Citations (Scopus)

Abstract

Objectives: The high mortality among HIV/tuberculosis (TB) coinfected patients in Eastern Europe is partly explained by the high prevalence of drug-resistant TB. It remains unclear whether outcomes of HIV/TB patients with rifampicin/isoniazid-susceptible TB in Eastern Europe differ from those in Western Europe or Latin America. Methods: One-year mortality of HIV-positive patients with rifampicin/isoniazidsusceptible TB in Eastern Europe, Western Europe, and Latin America was analysed and compared in a prospective observational cohort study. Factors associated with death were analysed using Cox regression models Results: Three hundred and forty-one patients were included (Eastern Europe 127, Western Europe 165, Latin America 49). Proportions of patients with disseminated TB (50, 58, 59%) and initiating rifampicin+isoniazid+pyrazinamide-based treatment (93, 94, 94%) were similar in Eastern Europe, Western Europe, and Latin America respectively, whereas receipt of antiretroviral therapy at baseline and after 12 months was lower in Eastern Europe (17, 39, 39%, and 69, 94, 89%). The 1-year probability of death was 16% (95% confidence interval 11-24%) in Eastern Europe, vs. 4% (2-9%) in Western Europe and 9% (3-21%) in Latin America; P<0.0001. After adjustment for IDU, CD4+ cell count and receipt of antiretroviral therapy, those residing in Eastern Europe were at nearly 3-fold increased risk of death compared with those in Western Europe/Latin America (aHR 2.79 (1.15-6.76); P=0.023). Conclusions: Despite comparable use of recommended anti-TB treatment, mortality of patients with rifampicin/isoniazid-susceptible TB remained higher in Eastern Europe when compared with Western Europe/Latin America. The high mortality in Eastern Europe was only partially explained by IDU, use of ART and CD4+ cell count. These results call for improvement of care for TB/HIV patients in Eastern Europe.

Original language	English
Journal	AIDS
Volume	31
Issue number	3
Pages (from-to)	375-384
ISSN	0269-9370
DOIs	https://doi.org/10.1097/QAD.0000000000001333
Publication status	Published - 28 Jan 2017

Keywords

Adult
Antitubercular Agents/therapeutic use
Europe/epidemiology
Europe, Eastern/epidemiology
Female
HIV Infections/complications
Humans
Isoniazid/therapeutic use
Latin America/epidemiology
Male
Prospective Studies
Rifampin/therapeutic use
Survival Analysis
Tuberculosis/drug therapy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1097/QAD.0000000000001333

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Podlekareva, DN., Schultze, A., Panteleev, A., Skrahina, AM., Miro, JM., Rakhmanova, A., Furrer, H., Miller, RF., Efsen, AMW., Losso, MH., Toibaro, J., Vassilenko, A., Girardi, E., Lundgren, JD., Mocroft, A., Post, FA., Kirk, O., & TB:HIV Study writing Group (2017). One-year mortality of HIV-positive patients treated for rifampicin- and isoniazid-susceptible tuberculosis in Eastern Europe, Western Europe, and Latin America. AIDS, 31(3), 375-384. https://doi.org/10.1097/QAD.0000000000001333

Podlekareva, DN, Schultze, A, Panteleev, A, Skrahina, AM, Miro, JM, Rakhmanova, A, Furrer, H, Miller, RF, Efsen, AMW, Losso, MH, Toibaro, J, Vassilenko, A, Girardi, E, Lundgren, JD, Mocroft, A, Post, FA, Kirk, O & TB:HIV Study writing Group 2017, 'One-year mortality of HIV-positive patients treated for rifampicin- and isoniazid-susceptible tuberculosis in Eastern Europe, Western Europe, and Latin America', AIDS, vol. 31, no. 3, pp. 375-384. https://doi.org/10.1097/QAD.0000000000001333

@article{2af02452ccd345cdaecb617bbbcde38e,

title = "One-year mortality of HIV-positive patients treated for rifampicin- and isoniazid-susceptible tuberculosis in Eastern Europe, Western Europe, and Latin America",

abstract = "Objectives: The high mortality among HIV/tuberculosis (TB) coinfected patients in Eastern Europe is partly explained by the high prevalence of drug-resistant TB. It remains unclear whether outcomes of HIV/TB patients with rifampicin/isoniazid-susceptible TB in Eastern Europe differ from those in Western Europe or Latin America. Methods: One-year mortality of HIV-positive patients with rifampicin/isoniazidsusceptible TB in Eastern Europe, Western Europe, and Latin America was analysed and compared in a prospective observational cohort study. Factors associated with death were analysed using Cox regression models Results: Three hundred and forty-one patients were included (Eastern Europe 127, Western Europe 165, Latin America 49). Proportions of patients with disseminated TB (50, 58, 59%) and initiating rifampicin+isoniazid+pyrazinamide-based treatment (93, 94, 94%) were similar in Eastern Europe, Western Europe, and Latin America respectively, whereas receipt of antiretroviral therapy at baseline and after 12 months was lower in Eastern Europe (17, 39, 39%, and 69, 94, 89%). The 1-year probability of death was 16% (95% confidence interval 11-24%) in Eastern Europe, vs. 4% (2-9%) in Western Europe and 9% (3-21%) in Latin America; P<0.0001. After adjustment for IDU, CD4+ cell count and receipt of antiretroviral therapy, those residing in Eastern Europe were at nearly 3-fold increased risk of death compared with those in Western Europe/Latin America (aHR 2.79 (1.15-6.76); P=0.023). Conclusions: Despite comparable use of recommended anti-TB treatment, mortality of patients with rifampicin/isoniazid-susceptible TB remained higher in Eastern Europe when compared with Western Europe/Latin America. The high mortality in Eastern Europe was only partially explained by IDU, use of ART and CD4+ cell count. These results call for improvement of care for TB/HIV patients in Eastern Europe.",

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author = "DN Podlekareva and A Schultze and A Panteleev and AM Skrahina and JM Miro and A Rakhmanova and H Furrer and RF Miller and AMW Efsen and MH Losso and J Toibaro and A. Vassilenko and E Girardi and JD Lundgren and A Mocroft and FA Post and O Kirk and {TB:HIV Study writing Group}",

year = "2017",

month = jan,

day = "28",

doi = "10.1097/QAD.0000000000001333",

language = "English",

volume = "31",

pages = "375--384",

journal = "AIDS, Supplement",

issn = "1350-2840",

publisher = "Lippincott Williams & Wilkins",

number = "3",

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TY - JOUR

T1 - One-year mortality of HIV-positive patients treated for rifampicin- and isoniazid-susceptible tuberculosis in Eastern Europe, Western Europe, and Latin America

AU - Podlekareva, DN

AU - Schultze, A

AU - Panteleev, A

AU - Skrahina, AM

AU - Miro, JM

AU - Rakhmanova, A

AU - Furrer, H

AU - Miller, RF

AU - Efsen, AMW

AU - Losso, MH

AU - Toibaro, J

AU - Vassilenko, A.

AU - Girardi, E

AU - Lundgren, JD

AU - Mocroft, A

AU - Post, FA

AU - Kirk, O

AU - TB:HIV Study writing Group

PY - 2017/1/28

Y1 - 2017/1/28

N2 - Objectives: The high mortality among HIV/tuberculosis (TB) coinfected patients in Eastern Europe is partly explained by the high prevalence of drug-resistant TB. It remains unclear whether outcomes of HIV/TB patients with rifampicin/isoniazid-susceptible TB in Eastern Europe differ from those in Western Europe or Latin America. Methods: One-year mortality of HIV-positive patients with rifampicin/isoniazidsusceptible TB in Eastern Europe, Western Europe, and Latin America was analysed and compared in a prospective observational cohort study. Factors associated with death were analysed using Cox regression models Results: Three hundred and forty-one patients were included (Eastern Europe 127, Western Europe 165, Latin America 49). Proportions of patients with disseminated TB (50, 58, 59%) and initiating rifampicin+isoniazid+pyrazinamide-based treatment (93, 94, 94%) were similar in Eastern Europe, Western Europe, and Latin America respectively, whereas receipt of antiretroviral therapy at baseline and after 12 months was lower in Eastern Europe (17, 39, 39%, and 69, 94, 89%). The 1-year probability of death was 16% (95% confidence interval 11-24%) in Eastern Europe, vs. 4% (2-9%) in Western Europe and 9% (3-21%) in Latin America; P<0.0001. After adjustment for IDU, CD4+ cell count and receipt of antiretroviral therapy, those residing in Eastern Europe were at nearly 3-fold increased risk of death compared with those in Western Europe/Latin America (aHR 2.79 (1.15-6.76); P=0.023). Conclusions: Despite comparable use of recommended anti-TB treatment, mortality of patients with rifampicin/isoniazid-susceptible TB remained higher in Eastern Europe when compared with Western Europe/Latin America. The high mortality in Eastern Europe was only partially explained by IDU, use of ART and CD4+ cell count. These results call for improvement of care for TB/HIV patients in Eastern Europe.

AB - Objectives: The high mortality among HIV/tuberculosis (TB) coinfected patients in Eastern Europe is partly explained by the high prevalence of drug-resistant TB. It remains unclear whether outcomes of HIV/TB patients with rifampicin/isoniazid-susceptible TB in Eastern Europe differ from those in Western Europe or Latin America. Methods: One-year mortality of HIV-positive patients with rifampicin/isoniazidsusceptible TB in Eastern Europe, Western Europe, and Latin America was analysed and compared in a prospective observational cohort study. Factors associated with death were analysed using Cox regression models Results: Three hundred and forty-one patients were included (Eastern Europe 127, Western Europe 165, Latin America 49). Proportions of patients with disseminated TB (50, 58, 59%) and initiating rifampicin+isoniazid+pyrazinamide-based treatment (93, 94, 94%) were similar in Eastern Europe, Western Europe, and Latin America respectively, whereas receipt of antiretroviral therapy at baseline and after 12 months was lower in Eastern Europe (17, 39, 39%, and 69, 94, 89%). The 1-year probability of death was 16% (95% confidence interval 11-24%) in Eastern Europe, vs. 4% (2-9%) in Western Europe and 9% (3-21%) in Latin America; P<0.0001. After adjustment for IDU, CD4+ cell count and receipt of antiretroviral therapy, those residing in Eastern Europe were at nearly 3-fold increased risk of death compared with those in Western Europe/Latin America (aHR 2.79 (1.15-6.76); P=0.023). Conclusions: Despite comparable use of recommended anti-TB treatment, mortality of patients with rifampicin/isoniazid-susceptible TB remained higher in Eastern Europe when compared with Western Europe/Latin America. The high mortality in Eastern Europe was only partially explained by IDU, use of ART and CD4+ cell count. These results call for improvement of care for TB/HIV patients in Eastern Europe.

KW - Adult

KW - Antitubercular Agents/therapeutic use

KW - Europe/epidemiology

KW - Europe, Eastern/epidemiology

KW - Female

KW - HIV Infections/complications

KW - Humans

KW - Isoniazid/therapeutic use

KW - Latin America/epidemiology

KW - Male

KW - Prospective Studies

KW - Rifampin/therapeutic use

KW - Survival Analysis

KW - Tuberculosis/drug therapy

U2 - 10.1097/QAD.0000000000001333

DO - 10.1097/QAD.0000000000001333

M3 - Journal article

C2 - 28081036

SN - 1350-2840

VL - 31

SP - 375

EP - 384

JO - AIDS, Supplement

JF - AIDS, Supplement

IS - 3

ER -

One-year mortality of HIV-positive patients treated for rifampicin- and isoniazid-susceptible tuberculosis in Eastern Europe, Western Europe, and Latin America

Abstract

Keywords

UN SDGs

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