[Recurrent tuberculosis in patients with coinfection by HIV].
OBJECTIVE
Analysis and identification of factors associated with the tuberculosis (TB) recurrence in HIV-infected patients.


METHODS
The HIV-infected patients diagnosed with TB between 1995-2000 and with correct completion of the treatment were selected. There were compared those patients who presented a tuberculous disease recurrence with those which did not presented it. Multivariate analysis was carried out by logistic regression in order to identify factors associated with a new episode of TB.


RESULTS
In the total sample of 223 diagnosed HIV-infected patients with TB, 159 (71.3%) patients completed adequately the treatment and were considered cured. The rest were excluded because of: death before completing the treatment (5.8%), lost in the follow-up (11.7%), therapeutic abandonment (9.4%), and therapeutic failure (1.8%). In the 159 patient final sample, 14 (8.8%) patients presented later recurrence. The patients with recurrent TB presented a greater degree of immunosuppression, more previous complications indicative of AIDS, and greater frequency of extrapulmonary TB in the initial episode. After the multivariate analysis, a count of lymphocytes CD4 lower than 100/mm3 in the first episode of TB was associated with recurrent tuberculous disease (odds ratio [OR]: 4,6; 95% confidence index [CI]: 1,3-18,2). Mortality was high (35.7%) in the patients with recurrent episodes.


CONCLUSIONS
The recurrence of TB in patients coinfected by HIV occurs in individuals with profound immunossuppression and is associated to high mortality.
García Ordóñez
M A
MA
Unidad de Enfermedades Infecciosas. Servicio de Medicina Interna. Complejo Hospitalario Carlos Haya. Málaga. Spain. magarcia@han.sas.cica.es
Martínez González
J
J
Orihuela Cañadas
F
F
Jiménez Oñate
F
F
Colmenero Castillo
J D
JD
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D015497:HIV-1; D006801:Humans; D008297:Male; D012008:Recurrence; D017211:Treatment Failure; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
D000995:Antitubercular Agents