Abstract
Introduction: There is little information from Ukraine about the effect of highly active antiretroviral therapy (HAART) on survival of HIV/ TB-infected patients. We evaluated the survival and the effect of HAART on mortality on these patients. Methods: Prospective cohort study of HIV patients who developed TB from January 2005 to December 2006 in a Zaporizhzhya AIDS Center, and were tracked for 60 months after start HAART. Survival was determined by Kaplan-Meier method and effect of HAART on survival was evaluated using Cox proportional hazards models. Results: Eighty patients were studied (mean age 34 years, 50% male, median CD4 count 103 cell/μL). In 60 months of HAART 14 patients died. The probability of survival was 82%. In multivariate analysis, patients with a CD4 cell count <100 μL had a 5-fold higher risk of mortality (HR 5, 2; 95% CI 1.4-19, 4) and those with extra pulmonary tuberculosis a 2, 2-fold increased risk (HR 2, 2, 95% CI 1, 1-8, 3). Conclusions: HAART significantly increased probability of survival and reduced the risk of death for HIV/TB-infected patients in Ukraine.
Highlights
There is little information from Ukraine about the effect of highly active antiretroviral therapy (HAART) on survival of HIV/ TB-infected patients
Among the 5 patients with HIV-related deaths that occurred during the first 12 months of HAART, we identified 4 in whom death could be attributed to IRIS
Univariate analysis revealed that a baseline CD4 cell count
Summary
There is little information from Ukraine about the effect of highly active antiretroviral therapy (HAART) on survival of HIV/ TB-infected patients. Conclusions: HAART significantly increased probability of survival and reduced the risk of death for HIV/TB-infected patients in Ukraine. Prior to the introduction of highly active antiretroviral therapy (HAART), a wide range of survival times in people with TB-HIV was reported [47]. Some of these reports showed associations between immunosuppression, history of AIDS and TB location with risk of death [5,6]. We conducted the present study to determine the survival rate among HIV/TB-infected patients who received HAART. This study aimed to determine possible risk factors that related to death among these patients and the appropriate timing for initiating HAART after TB diagnosis
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