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首页> 外文期刊>Developmental Immunology: Journal of Immunology Research >Impact of Previous ART and of ART Initiation on Outcome of HIV-Associated Tuberculosis
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Impact of Previous ART and of ART Initiation on Outcome of HIV-Associated Tuberculosis

机译：既往抗病毒药物和抗病毒药物治疗对艾滋病毒相关结核病结局的影响

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Background. Combination antiretroviral therapy (cART) has progressively decreased mortality of HIV-associated tuberculosis .To date, however, limited data on tuberculosis treatment outcomes among coinfected patients who are not ART-naive at the time of tuberculosis diagnosis are available.Methods. A multicenter, observational study enrolled 246 HIV-infected patients diagnosed with tuberculosis, in 96 Italian infectious diseases hospital units, who started tuberculosis treatment. A polytomous logistic regression model was used to identify baseline factors associated with the outcome. A Poisson regression model was used to explain the effect of ART during tuberculosis treatment on mortality, as a time-varying covariate, adjusting for baseline characteristics.Results. Outcomes of tuberculosis treatment were as follows: 130 (52.8%) were successfully treated, 36 (14.6%) patients died in a median time of 2 months (range: 0–16), and 80 (32.6%) had an unsuccessful outcome. Being foreign born or injecting drug users was associated with unsuccessful outcomes. In multivariable Poisson regression, cART during tuberculosis treatment decreased the risk of death, while this risk increased for those who were not ART-naive at tuberculosis diagnosis.Conclusions. ART during tuberculosis treatment is associated with a substantial reduction of death rate among HIV-infected patients. However, patients who are not ART-naive when they develop tuberculosis remain at elevated risk of death.
机译：背景。联合抗逆转录病毒疗法（cART）逐渐降低了HIV相关结核病的死亡率。一项多中心的观察性研究纳入了96个意大利传染病医院的246名开始接受结核病治疗的被艾滋病毒感染的结核病患者。使用多因素逻辑回归模型来确定与结果相关的基线因素。使用Poisson回归模型来解释结核治疗期间抗逆转录病毒疗法对死亡率的影响，作为随时间变化的协变量，并根据基线特征进行了调整。结核病的治疗结果如下：成功治疗了130名（52.8％），在2个月的中位时间（0-16）死亡了36名（14.6％），结果未成功的有80名（32.6％）。在国外出生或注射吸毒者与失败的结果有关。在多变量Poisson回归中，结核病治疗期间的cART降低了死亡风险，而对于结核病诊断不熟练的人则增加了死亡风险。结核病治疗期间的抗逆转录病毒治疗与艾滋病毒感染患者的死亡率大幅降低有关。但是，在患结核病时未接受过抗病毒治疗的患者仍处于较高的死亡风险中。

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