[Deaths of patients with tuberculosis in combination with HIV infection from various causes, other than tuberculosis].
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The structure of tuberculosis patients with HIV infection who died from any causes, other than tuberculosis, in the Sverdlovsk Region in 2000-2006 did not differ from that of patients with concurrent pathology who died from tuberculosis. The general health care facilities had revealed tuberculosis during life in most patients who died from terminal-stage HIV infection; at death these patients had endstage HIV infection which tuberculosis joined to 4 years or more after HIV infection registration. A fatal outcome in 88.1% of the patients died from the terminal stage of HIV infection was observed within the first year after tuberculosis detection, in half the cases the background disease being generalized tuberculosis at autopsy; every two patients discharged microorganisms during life, drug resistance in the causative agent of tuberculosis was found in every three patients. Half the patients who died from other causes, other than HIV infection and tuberculosis lost their life within the first year after registration of the tuberculous process. Lifetime bacterial discharge was recorded in half the patients; drug resistance of Mycobacterium tuberculosis has developed a third of the patients with comorbidity who died from other causes, other than tuberculosis and HIV infection. The volume of lifetime specialized care for HIV infection to deceased patients with comorbidity had been inadequate. The importance of the problem of notification of cases, when the autopsy background disease was tuberculosis in comorbidity patients not included into the regional tuberculosis morbidity and mortality statistics, will increase with further development of the epidemics of tuberculosis and HIV infection to the Svedlovsk Region.Cite
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Tuberculosis is one of the most common causes of hospitalisation in patients with HIV. Despite this, hospital outcomes of patients with this co-infection have rarely been described since antiretroviral therapy became widely available.Prospective cohort study of HIV-infected adult patients hospitalised with TB in six referral hospitals in Medellin, Colombia, from August 2014 to July 2015.Among 128 HIV-infected patients hospitalised with tuberculosis, the mean age was 38.4 years; 79.7% were men. HIV was diagnosed on admission in 28.9% of patients. The median CD4 + T-cell count was 125 (±158 SD) cells/µL. Only 47.3% of patients with a known diagnosis of HIV upon admission were on antiretroviral therapy, and only 11.1% had a tuberculin skin test in the previous year. Drug toxicity due to tuberculosis medications occurred in 11.7% of patients. Mean length of stay was 23.2 days, and 10.7% of patients were readmitted. Mortality was 5.5%.Hospital mortality attributable to tuberculosis in patients with HIV is low in reference hospitals in Colombia. Cases of tuberculosis in HIV-infected patients occur mainly in patients with advanced HIV, or not on antiretroviral therapy, despite a known diagnosis of HIV. Only one of every 10 patients in this cohort had active screening for latent tuberculosis, possibly reflecting missed treatment opportunities.La tuberculose (TB) est l'une des causes les plus courantes d'hospitalisation chez les patients VIH positifs. Malgré cela, les résultats hospitaliers des patients atteints de cette coinfection ont rarement été décrits depuis que le traitement antirétroviral est devenu largement disponible. MÉTHODES: Etude de cohorte prospective de patients adultes infectés par le VIH hospitalisés pour TB dans six hôpitaux de référence à Medellin, en Colombie, d'août 2014 à juillet 2015. RÉSULTATS: Sur 128 patients infectés par le VIH hospitalisés pour TB, l'âge moyen était de 38,4 ans; 79,7% étaient des hommes. Le VIH a été diagnostiqué à l'admission chez 28,9% des patients. Le nombre médian de lymphocytes T CD4+ était de 125 (±158 SD) cellules/µL. Seuls 47,3% des patients dont le diagnostic de VIH était connu lors de leur admission étaient sous traitement antirétroviral et 11,1% seulement avaient subi un test cutané à la tuberculine l'année précédente. Une toxicité médicamenteuse due aux médicaments antituberculeux est survenue chez 11,7% des patients. La durée moyenne de séjour était de 23,2 jours et 10,7% des patients ont été réadmis. La mortalité était de 5,5%.La mortalité hospitalière attribuable à la TB chez les patients VIH positifs est faible dans les hôpitaux de référence en Colombie. Les cas de TB chez les patients infectés par le VIH surviennent principalement chez les patients à un stade avancé du VIH, ou qui ne sont pas sous traitement antirétroviral, malgré un diagnostic connu de VIH. Seul un patient sur 10 de cette cohorte a subi un dépistage actif de la TB latente, ce qui reflète peut-être des opportunités de traitement manquées.
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The paper describes the follow-up and treatment of patients with tuberculosis concurrent with HIV infection in Moscow in 2004-2005. Major epidemiological parameters, such as morbidity, mortality, and prevalence of this comorbidity, are given. Analysis of these indices suggests that the epidemic situation associated with tuberculosis concurrent with HIV infection became worse in the past 2 years. As compared with 2004, in 2005 the number of such patients increased from 294 to 445, including that of first detected patients rose from 123 to 174. In this group of patients, there was a preponderance of young males aged 29 to 39 years. Most patients with this pathology suffered from drug addiction and alcoholism and other concomitant diseases. The bulk of them were unemployed and disabled. In the HIV-infected, the clinical forms of tuberculosis were severe with a predominance of acute and disseminated processes; the rate of drug resistance, including multidrug resistance, was high, which made treatment difficult and resulted in high mortality.
Concomitant
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Tuberculosis is the most common opportunistic infection among people infected with human immunodeficiency virus and its first cause of morbidity and mortality.To analyze the characteristics of a population in Israel with both tuberculosis disease and HIV infection in order to identify factors that contribute to outcome.The study group comprised patients hospitalized in the Pulmonary and Tuberculosis Department of Shmuel Harofeh Hospital during the period January 2000 to December 2006. They were located by a computer search of the hospital registry and the pertinent data were collected.During the study period 1059 cases of active tuberculosis disease were hospitalized; 93 of them were co-infected with HIV. Most of them came from endemic countries (61.2% from Ethiopia and 20.4% from the former Soviet Union; none of them was born in Israel). Ten percent of the cases were multiple-drug resistant and 32% showed extrapulmonary involvement. The response rate to the treatment was good, and the median hospitalization time was 70 days. The mortality rate was 3.2%.Despite the high prevalence of pulmonary disease in our group, the short-term outcome was good and the Mycobacterium was highly sensitive to first-line drugs. These encouraging results can be attributed to the fact that tuberculosis patients in Israel are identified early and treated continuously and strictly, with early initiation of antiretroviral therapy, which together ensure that the development of drug resistance is low.
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One of the most common secondary diseases HIV-infected patients may have is the tuberculosis. Recently the issue whether the tuberculosis causes the death of HIV-infected patients has been raised a lot.
The goals: to estimate a situation according to the mortality level of patients in a tubercular hospital in a city with high diffusion of HIV.
Reference sources and methods: the death analysis of 437 patients in 2012 and 2013 (6 months) has been carried out in Samara tubercular hospital. Among them 297 people (66,4 %) are HIV-infected. 66,7 % of patients have died of AIDS with concurrent tuberculosis and 33,3% of them have died of tuberculosis combined with HIV-infection. In accordance with this the groups have been formed: 1st group - 198 patients, 2nd-99 patients.
Results: Among dead patients men prevail, in the first group the number of them comprises 120 (60,6 %), in the second group it is 72 (72,8 %). Patients died in the efficient age from 21 to 40 years: 1st group comprises 29± 3,2 (85 %), the second one - 35 ±4,6 (35 %). The HIV has been revealed before tuberculosis in 1st group in 85 % of all cases (thus patients have been infected more than 7 years ago), in the second one it happened in 64 %. In the second group where tuberculosis was a cause of death, at postmortem examination by a cause of death was disseminated tuberculosis in 49 (24,7 %) cases, miliary tuberculosis at 19 (9,6 %), a caseous pneumonia at 13 (6,6 %), a tubercular meningitis at 7 (3,5 %), cavitary disease at 11 (5,5 %). In the first group brain edema with foramen magnum herniation was a cause of death in 80 %.
Conclusion. 80% of HIV -infected patients with a tuberculosis had lethal outcomes because of the end-stage of a HIV - AIDS.
Miliary tuberculosis
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Goal of the study: to study the changes in parameters of the group of patients with concurrent HIV infection and tuberculosis during 3 year follow-up. Materials and methods. During first 6 months of 2011 80 patients were enrolled for follow-up provided that they had HIV infection and tuberculosis detected after 01.01.2011. This group was monitored every 6 months during 3 years. Results. Changes occurring every six months have been described. By the completion of 3 year period tuberculosis was cured in 43.5%, 47.5% died, 3.75% lost for follow-up (n = 3), and 4 patients (5%) continued treatment of tuberculosis. The majority of those with lethal outcome died during the 2nd year of follow-up, which made 50% of all died. The cause of death was the HIV-associated disease in 29 patients, which made 76.3% of all died. Progression of tuberculosis was observed in 16 (55.2%) patients out of 29 those died. 9 (23.7%) patients died due to non-infectious causes of death (overdose of substances, traumas and other).
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Pulmonary tuberculosis is an air born infectious disease caused by Mycobacterium tuberculosis and is a major cause of morbidity and mortality particularly in developing countries. There are 33 million cases of tuberculosis worldwide, 3 million annual deaths and 8 million persons developed active tuberculosis every year. If tuberculosis is detected early and fully treated, people with the disease quickly become non-infectious and are eventually cured. However multi-drug resistance tuberculosis, HIV associated tuberculosis and weak health system are the major challenges. An observational study was conducted over a period of one year from September 2015 to August 2016 in the Outpatient Department of Jahurul Islam Medical College Hospital and Department of Pathology, Jahurul Islam Medical College, Kishoregonj, Bangladesh. Most of the patients were in the age group of 15-34 years (61.7%). 69.6% of the patients belonged to lower income group. 50.9% patients had pulmonary tuberculosis, 43.7% patients had extra pulmonary tuberculosis and 5.4% had both pulmonary and extra pulmonary tuberculosis. The most common symptoms observed in pulmonary tuberculosis patients were cough with expectoration (96.5%) followed by weight loss (80.7%), fever (73.7%) and loss of appetite (54.4%) whereas in extrapulmonary tuberculosis patient’s majority had weight loss (79.6%), fever (67,3%), loss of appetite (61.2%).
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The proportion of those who died at a hospital in 2001 is 3.8% of the treated patients and that in 2002 is 4.2%. In 2003, mortality rates increased more than 3-fold and accounted for 13.4%. Patients with a long history of tuberculosis were found to have pulmonary tuberculosis without extrapulmonary foci. Generalized forms of tuberculosis were detectable in more than a third of the cases and more frequently encountered in patients with significant immunodeficiency for whom tuberculosis was opportunistic infection.
Extrapulmonary tuberculosis
Opportunistic infection
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In order to study the profile of patients who died of pulmonary tuberculosis with positive smear under tuberculosis chemotherapy and the impact of HIV status, a prospective study over eight months from 1 November 2005 to 30 June 2006 was conducted in tuberculosis department CHU point G. Among patients hospitalized for tuberculosis all forms, 73 cases of pulmonary tuberculosis were recorded including 54 sputum smear-positive (73.9%). The analysis focused on 28 deaths among pulmonary tuberculosis smear positive (prevalence of 51,85%). The age group of 16-35 years was the most represented with a sex ratio of 2.5. The different causes of morbidity which had a negative influence on the lethality of TB patients in order of importance were: the extent of the lesions (71.4%), HIV/AIDS status (63.15%), smoking (50 %) and a history of tuberculosis (25%) (p = 0.02). The deaths occurred early during the first week of hospitalization. The search for morbidity factors in any patient with tuberculosis should be systematical to improve their care.
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