Almaty City Center of Prevention and Control of AIDS, Almaty, Kazakhstan.
FMD KL Europe, Yerevan, Armenia.
J Infect Dev Ctries. 2020 Nov 16;14(11.1):116S-121S. doi: 10.3855/jidc.11955.
HIV/TB comorbidity is responsible for 1.6 million deaths worldwide. HIV/TB control and patients' survival are still among priorities of the national HIV and TB programs. We aimed to evaluate the HIV/TB survival in connection with TB treatment outcomes and factors influencing life duration of the cohort 2008-2018 in Almaty, Kazakhstan.
This retrospective cohort study extracted data for all HIV and pulmonary TB adults coinfected during 2008-2018 in Almaty from national registries to apply descriptive, Kaplan-Meier estimation, and Cox proportional hazards regression model. Survival function for the TB treatment outcomes and factors predicting the probability of survival were tested and described.
The cohort population (n = 521) mean age was 37.4 years with 405 (77.7%) males and 210 (40.3%) marrieds. More than one TB treatment had 181 (34.7%) patients, 291 (55.9%) were smear-positive (SS+), and 423 (81.2%) were on antiretroviral therapy with mean CD4 count 254.22cells/µL. Probability to live longer was higher (128 versus 37 months, p = 0.003; 95% confidence interval (CI) 71.65, 184.35) for those who succeeded in TB treatment compared to "lost to follow-up" and "failed" treatment outcomes. Adjusted Cox regression model death hazard showed association with missing ART treatment (HR: 1.699, 95%CI 1.164, 2.481, p = 0.006) and having CD4 count < 499 (HR 2.398, 95%CI 1.191, 4.830, p < 0.014).
TB treatment outcomes, ART treatment, and the CD4 count of HIV/TB coinfected population substantially influence their life duration. The medical decision- and policy-makers should take this into consideration when implementing targeted improvements in the national HIV and TB programs.
HIV/TB 合并感染在全球范围内导致 160 万人死亡。HIV/TB 控制和患者的生存仍然是国家 HIV 和 TB 规划的重点。我们旨在评估 2008-2018 年哈萨克斯坦阿拉木图 HIV/TB 生存与 TB 治疗结果的关系，以及影响队列生存时间的因素。
这项回顾性队列研究从国家登记处提取了 2008-2018 年期间所有 HIV 和肺 TB 成人合并感染的数据，应用描述性、Kaplan-Meier 估计和 Cox 比例风险回归模型。测试并描述了 TB 治疗结果和预测生存概率的因素对生存功能的影响。
队列人群（n=521）平均年龄为 37.4 岁，其中 405 人（77.7%）为男性，210 人（40.3%）为已婚。超过一次 TB 治疗的患者有 181 人（34.7%），291 人（55.9%）为涂片阳性（SS+），423 人（81.2%）接受抗逆转录病毒治疗，平均 CD4 计数为 254.22 个/µL。与“失访”和“治疗失败”相比，成功治疗 TB 的患者存活时间更长（128 个月与 37 个月，p=0.003；95%置信区间（CI）71.65，184.35）。调整后的 Cox 回归模型死亡风险显示，与 ART 治疗缺失（HR：1.699，95%CI 1.164，2.481，p=0.006）和 CD4 计数<499（HR 2.398，95%CI 1.191，4.830，p<0.014）相关。
HIV/TB 合并感染人群的 TB 治疗结果、ART 治疗和 CD4 计数对其生存时间有实质性影响。医疗决策和政策制定者在实施国家 HIV 和 TB 规划的有针对性改进时应考虑到这一点。
