Predictors of survival in HIV-infected tuberculosis patients.
OBJECTIVE
To ascertain predictors of survival in HIV-infected tuberculosis (TB) patients.


METHODS
Retrospective cohort study.


METHODS
New York City public hospital.


METHODS
Fifty-four consecutive HIV-seropositive patients with newly diagnosed TB and no other AIDS-defining illnesses.


METHODS
CD4+ T-lymphocyte counts, completion of anti-TB therapy, repeat hospitalizations with TB, and survival.


RESULTS
Forty-five (84%) of the 54 patients died a median of 15 months after TB diagnosis (range, 1-80 months), five (9%) were alive after a median of 81 months (range, 75-84 months), and four (7%) were lost to follow-up after a median of 42 months (range, 30-66 months). In univariate analyses, disseminated TB, intrathoracic adenopathy, oral candidiasis and CD4 count depletion were each associated with decreased survival. In a multivariate analysis, CD4 count depletion was the only independent predictor of decreased survival. Repeat hospitalization with TB occurred in 10 out of 15 patients who did not complete anti-TB therapy compared with one out of 21 patients who completed anti-TB therapy (P < 0.001).


CONCLUSIONS
The clinical presentation of TB and CD4 count at TB diagnosis are each predictive of survival in HIV-seropositive TB patients. The CD4 count is the only independent predictor of survival.
Shafer
R W
RW
Division of Infectious Diseases, Stanford University Medical Center, Stanford, CA 94305, USA.
Bloch
A B
AB
Larkin
C
C
Vasudavan
V
V
Seligman
S
S
Dehovitz
J D
JD
DiFerdinando
G
G
Stoneburner
R
R
Cauthen
G
G
D000328:Adult; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000401:mortality*; D006801:Humans; D008297:Male; D009519:New York City / Q000453:epidemiology; D010349:Patient Compliance; D012189:Retrospective Studies; D016019:Survival Analysis; D017211:Treatment Failure; D014376:Tuberculosis / Q000150:complications / Q000453:epidemiology / Q000401:mortality*