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首页> 外文期刊>The open AIDS journal >Short and Long-Term Incidence of Tuberculosis and CD4-Cell Count Dynamic on HAART in Senegal
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Short and Long-Term Incidence of Tuberculosis and CD4-Cell Count Dynamic on HAART in Senegal

机译：塞内加尔HAART上结核病的短期和长期发病及CD4-细胞计数的动态

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Objectives: Estimate tuberculosis (TB) incidence among patients receiving HAART. Compare the dynamic of the CD4-cell count and viral load before notification of the TB with the dynamic among patients remaining free of TB. Design: Prospective cohort with ascertainment of TB cases from medical records. Methods: The first 404 adults HIV-1 infected patients enrolled in the Senegalese antiretroviral drug access initiative were eligible. CD4-cell and viral load were assessed at baseline and every 6 months. Patients receiving an antituberculosis treatment at HAART initiation were excluded from analysis. Any TB case notified after the first month of HAART was considered as an incident case. Follow-up was censored at death or at the last visit before March 31, 2008. CD4-cell trajectories until TB notification were compared to non-TB developers within two distinct periods: from HAART initiation to 24 months and after. Results: Over 404 eligible patients, 352 were included in this analysis. Median follow-up reached 73 months and 1821 person-years were accrued. Half of the 42 incident cases were notified before month 19 of HAART yielding to an overall incident rate of 2.3/100 PY [1.7-3.1]. Annual incidence decreased with duration of HAART (trend in incidence: RR=0.26, p<10-4). During the first period, CD4-cell count dynamic of most TB patients was identical to the dynamic among patients remaining free of TB. Most cases of the second period occurred in a context of an immunological failure.Conclusions: This study provides an estimate of TB incidence among patients on HAART in Senegal and supports two underlying mechanisms.
机译：目的：估计接受HAART的患者中结核病（TB）的发生率。在通知结核病之前，将CD4细胞计数和病毒载量的动态与未患结核病的患者之间的动态进行比较。设计：前瞻性队列，从病历中确定结核病病例。方法：参加塞内加尔抗逆转录病毒药物获取计划的首批404名成人HIV-1感染患者是合格的。在基线和每6个月评估一次CD4细胞和病毒载量。从HAART开始接受抗结核治疗的患者被排除在分析之外。 HAART第一个月后通报的任何结核病病例均视为事件病例。在死亡或2008年3月31日之前的最后一次访视中对随访进行检查。在两个不同的时期内（从HAART启动到24个月及之后），将直到结核病通知之前的CD4细胞轨迹与非结核病开发商进行了比较。结果：超过404名合格患者，其中352名被纳入分析。中位随访时间为73个月，已累计1821人年。在42个事件案例中，有一半在HAART的第19个月之前得到通知，总事件发生率为2.3 / 100 PY [1.7-3.1]。年发生率随HAART持续时间的延长而下降（发生趋势：RR = 0.26，p <10-4）。在第一个阶段，大多数结核病患者的CD4细胞计数动态与其余无结核病患者的动态相同。结论：本研究提供了塞内加尔HAART患者中TB发病率的估计值，并支持了两种潜在机制。

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