Department of Statistics, College of Natural and Computational Science, Mizan-Tepi University, Tepi, Ethiopia.
Department of Statistics, College of Natural and Computational Science, Mettu University, Mettu, Ethiopia.
Sci Rep. 2022 Nov 1;12(1):18360. doi: 10.1038/s41598-022-23316-4.
Nowadays, Tuberculosis remains the major cause of HIV-associated mortality, which accounts for 1 out of every 5 HIV-related mortality worldwide. This study aimed to determine the survival rate and predictors of mortality among TB/HIV co-infected patients. An institution-based retrospective cohort study was undertaken on adult TB/HIV co-infected individuals between 1st February 2014 and 30th January 2022 at Mettu Karl Referral Hospital. A Cox regression model was used to identify predictors of survival time to death among TB/HIV co-infected patients. This study comprised 402 TB and HIV co-infected adult patients. Among these, 84 (20.9%) died, and 318 (79.1%) were censored. The study subjects have been followed up for 6920 person-months with an overall median survival time of 17.6 months. The overall incidence rate was 12.1 per 1000 person months [95% CI: 9.77-14.98]. The results of a multivariable Cox regression analysis showed that being at an older age, urban residence, WHO clinical stage II & IV, CD4 count of ≥ 200 cells/mm, bedridden functional status, using INH, and using CPT were associated with the survival time of TB and HIV co-infected patients at a significance level of alpha = 0.05. This retrospective study found that high mortality of TB/HIV co-infected patients occurred in the earlier months of treatment initiation. Close monitoring of patients with low CD4, who do not utilize CPT, who are in advanced WHO stages, and who have poor functional levels can help them improve their health and live longer.
如今,结核病仍然是导致艾滋病毒相关死亡的主要原因,占全球每 5 例与艾滋病毒相关死亡中的 1 例。本研究旨在确定结核和艾滋病毒合并感染患者的生存率和死亡预测因素。这是一项基于机构的回顾性队列研究,纳入了 2014 年 2 月 1 日至 2022 年 1 月 30 日期间在梅图卡尔转诊医院就诊的成年结核和艾滋病毒合并感染患者。使用 Cox 回归模型确定了结核和艾滋病毒合并感染患者死亡时间的生存预测因素。这项研究包括 402 名结核和艾滋病毒合并感染的成年患者。其中 84 人(20.9%)死亡,318 人(79.1%)被删失。研究对象的随访时间为 6920 人月,总中位生存时间为 17.6 个月。总发病率为 12.1 例/1000 人月[95%CI:9.77-14.98]。多变量 Cox 回归分析结果显示,年龄较大、居住在城市、世界卫生组织临床分期 II&IV、CD4 计数≥200 个细胞/mm、卧床不起的功能状态、使用异烟肼和环丝氨酸与结核和艾滋病毒合并感染患者的生存时间相关,具有统计学意义(α=0.05)。这项回顾性研究发现,结核和艾滋病毒合并感染患者在治疗开始的早期几个月死亡率较高。密切监测 CD4 较低、未使用环丝氨酸、处于晚期世界卫生组织阶段和功能状态较差的患者,有助于改善他们的健康状况,延长其寿命。