Gamboa-Acuña Brenda, Guillén-Zambrano Rayza, Lizzetti-Mendoza Grecia, Soto Alonso, Lucchetti-Rodríguez Aldo
Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Perú.
Hospital Nacional Arzobispo Loayza, Lima, Perú.
Rev Chilena Infectol. 2018;35(1):41-48. doi: 10.4067/s0716-10182018000100041.
Background The main cause of death in HIV patients is tuberculosis (TB). However, few Latin American studies have evaluated the prognosis of patients with coinfection. Aim To determine the factors associated with survival in patients with HIV-TB coinfection treated at a Peruvian referral hospital. Methods A retrospective cohort study was performed based on clinical records of patients treated at the Department of Infectious Diseases in the Arzobispo Loayza National Hospital from 2004 to 2012. Survival was assessed using the Kaplan-Meier estimator and Cox Proportional Hazard Model. Results From 315 patients, 82 died during the follow-up. The mean of follow for each patient was 730 days. The multivariate analysis showed that receiving HAART (HR: 0,31; IC: 0,20-0,50; p < 0,01) and having more weight (HR: 0,96; IC 0,94-0,98; p < 0,01) when the coinfection was diagnosed, were protective factors; while having a pathology different from TB (HR: 1,88; IC: 1,19-2,98; p < 0,01), age in years (HR: 1,76; IC: 1,12-2,74; p ≤ 0,01) and being hospitalized when diagnosed with TB (HR: 1,69; IC 1,02-2,80; p < 0,04) were associated with lower survival. Discussion Receiving HAART and having more weight when the coinfection is diagnosed were associated with a higher chance of survival.
艾滋病毒患者的主要死因是结核病(TB)。然而,拉丁美洲很少有研究评估合并感染患者的预后。目的:确定在秘鲁一家转诊医院接受治疗的艾滋病毒-结核病合并感染患者的生存相关因素。方法:基于2004年至2012年在阿索维斯波·洛阿萨国家医院传染病科接受治疗的患者临床记录进行回顾性队列研究。使用Kaplan-Meier估计器和Cox比例风险模型评估生存情况。结果:315名患者中,82名在随访期间死亡。每位患者的平均随访时间为730天。多变量分析显示,接受高效抗逆转录病毒治疗(HR:0.31;95%置信区间:0.20 - 0.50;p < 0.01)以及在合并感染被诊断时体重较重(HR:0.96;95%置信区间0.94 - 0.98;p < 0.01)是保护因素;而患有非结核病的其他疾病(HR:1.88;95%置信区间:1.19 - 2.98;p < 0.01)、年龄(HR:1.76;95%置信区间:1.12 - 2.74;p ≤ 0.01)以及在诊断结核病时住院(HR:1.69;95%置信区间1.02 - 2.80;p < 0.04)与较低的生存率相关。讨论:接受高效抗逆转录病毒治疗以及在合并感染被诊断时体重较重与较高的生存机会相关。