PMID- 30105915
OWN - NLM
STAT- MEDLINE
DCOM- 20200619
LR  - 20210109
IS  - 1931-8405 (Electronic)
IS  - 0889-2229 (Print)
IS  - 0889-2229 (Linking)
VI  - 34
IP  - 12
DP  - 2018 Dec
TI  - Treatment Complexities Among Patients with Tuberculosis in a High HIV Prevalence 
      Cohort in the United States.
PG  - 1050-1057
LID - 10.1089/AID.2018.0126 [doi]
AB  - The association between human immunodeficiency virus (HIV) infection and 
      tuberculosis (TB) mortality has been studied extensively, but the impact of HIV 
      on other clinically relevant aspects of TB care such as TB drug-related adverse 
      events (AEs), hospital readmissions, and TB treatment duration is less well 
      characterized. We describe the association of HIV infection with TB clinical 
      complexities and outcomes in a high HIV prevalence cohort in the United States. 
      This is a retrospective cohort study among patients treated for culture-confirmed 
      TB between 2008 and 2015 at an inner-city hospital in Atlanta, GA. Univariate 
      analysis was used to estimate association of HIV with TB treatment interruption 
      due to AEs, hospital readmissions, and treatment duration. Final unfavorable TB 
      treatment outcome was defined as death, loss to follow-up, or recurrent TB. 
      Logistic regression modeling was used to estimate association of HIV with final 
      unfavorable outcomes. Among 274 patients with TB, 96 (35%) had HIV coinfection. 
      HIV-positive patients had more TB treatment interruptions due to AE (34% vs. 
      15%), were more likely to have a hospital readmission (50% vs. 21%), and received 
      longer TB treatment (9.9 months vs. 8.8 months) compared to HIV-negative patients 
      (p < .01 for all). HIV infection was not associated with final unfavorable 
      outcomes in univariate [odds ratio (OR) = 1.86; confidence interval (95% CI) 
      0.99-3.49] or multivariate analysis (aOR = 1.13; 95% CI 0.52-2.39) (p >/= .05 for 
      both). While HIV infection was not associated with final unfavorable TB outcomes, 
      TB/HIV coinfected patients had more complex treatment course underscoring the 
      importance of maintaining resources and expertise to treat coinfected patients in 
      our and similar settings.
FAU - Bizune, Destani J
AU  - Bizune DJ
AD  - Rollins School of Public Health, Emory University, Atlanta, Georgia.
FAU - Kempker, Russell R
AU  - Kempker RR
AD  - Division of Infectious Diseases, Department of Medicine, Emory University School 
      of Medicine, Atlanta, Georgia.
FAU - Kagei, Michelle
AU  - Kagei M
AD  - Emory University, Atlanta, Georgia.
FAU - Yamin, Aliya
AU  - Yamin A
AD  - Communicable Disease Prevention Branch, Fulton County Board of Health, Atlanta, 
      Georgia.
FAU - Mohamed, Omar
AU  - Mohamed O
AD  - Communicable Disease Prevention Branch, Fulton County Board of Health, Atlanta, 
      Georgia.
FAU - Holland, David P
AU  - Holland DP
AD  - Division of Infectious Diseases, Department of Medicine, Emory University School 
      of Medicine, Atlanta, Georgia.
AD  - Communicable Disease Prevention Branch, Fulton County Board of Health, Atlanta, 
      Georgia.
FAU - Oladele, Alawode
AU  - Oladele A
AD  - DeKalb County Board of Health, Decatur, Georgia.
FAU - Wang, Yun F
AU  - Wang YF
AD  - Department of Pathology and Laboratory Medicine, Emory University School of 
      Medicine, Atlanta, Georgia.
AD  - Department of Pathology, Grady Memorial Hospital, Atlanta, Georgia.
FAU - Rebolledo, Paulina A
AU  - Rebolledo PA
AD  - Rollins School of Public Health, Emory University, Atlanta, Georgia.
AD  - Division of Infectious Diseases, Department of Medicine, Emory University School 
      of Medicine, Atlanta, Georgia.
FAU - Blumberg, Henry M
AU  - Blumberg HM
AD  - Rollins School of Public Health, Emory University, Atlanta, Georgia.
AD  - Division of Infectious Diseases, Department of Medicine, Emory University School 
      of Medicine, Atlanta, Georgia.
FAU - Ray, Susan M
AU  - Ray SM
AD  - Division of Infectious Diseases, Department of Medicine, Emory University School 
      of Medicine, Atlanta, Georgia.
FAU - Schechter, Marcos C
AU  - Schechter MC
AD  - Division of Infectious Diseases, Department of Medicine, Emory University School 
      of Medicine, Atlanta, Georgia.
LA  - eng
GR  - K23 AI103044/AI/NIAID NIH HHS/United States
GR  - R21 AI122001/AI/NIAID NIH HHS/United States
GR  - UL1 TR000454/TR/NCATS NIH HHS/United States
GR  - UL1 TR002378/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20180911
PL  - United States
TA  - AIDS Res Hum Retroviruses
JT  - AIDS research and human retroviruses
JID - 8709376
RN  - 0 (Antitubercular Agents)
SB  - IM
MH  - AIDS-Related Opportunistic Infections/*epidemiology/virology
MH  - Adult
MH  - Antitubercular Agents/adverse effects/*therapeutic use
MH  - Coinfection/*drug therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Georgia/epidemiology
MH  - HIV
MH  - Humans
MH  - Lost to Follow-Up
MH  - Male
MH  - Middle Aged
MH  - Mycobacterium tuberculosis/*genetics/isolation & purification
MH  - Patient Readmission
MH  - Prevalence
MH  - Recurrence
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Tuberculosis/*drug therapy/mortality/virology
PMC - PMC6306673
OTO - NOTNLM
OT  - HIV
OT  - adverse events
OT  - readmissions
OT  - tuberculosis
COIS- No competing financial interests exist.
EDAT- 2018/08/15 06:00
MHDA- 2020/06/20 06:00
PMCR- 2019/12/01
CRDT- 2018/08/15 06:00
PHST- 2018/08/15 06:00 [pubmed]
PHST- 2020/06/20 06:00 [medline]
PHST- 2018/08/15 06:00 [entrez]
PHST- 2019/12/01 00:00 [pmc-release]
AID - 10.1089/aid.2018.0126 [pii]
AID - 10.1089/AID.2018.0126 [doi]
PST - ppublish
SO  - AIDS Res Hum Retroviruses. 2018 Dec;34(12):1050-1057. doi: 10.1089/AID.2018.0126. 
      Epub 2018 Sep 11.