title: Tuberculosis incidence and risk factors among patients living with HIV/AIDS in public health service institutions in Brasilia, Federal District.
abstract: In order to estimate the incidence of and risk factors for developing tuberculosis, the clinical charts of a retrospective cohort of 281 HIV-positive adults, who were notified to the AIDS Program of the Health Department of Brasilia in 1998, were reviewed in 2003. All the patients were treatment-naive regarding antiretroviral therapy at the time of inclusion in the cohort. Twenty-nine patients were identified as having tuberculosis at the start of the study. Thirteen incident tuberculosis cases were identified during the 60 months of follow-up, with an incidence density rate of 1.24/100 person-years. Tuberculosis incidence was highest among patients with baseline CD4+ T-lymphocyte counts < or = 200 cells/microl who were not using antiretroviral therapy (incidence = 5.47; 95% CI = 2.73 to 10.94). Multivariate analysis showed that baseline CD4+ T-lymphocyte counts < or = 200 cells/microl (adjusted hazard ratio [AHR] = 5.09; 95% CI = 1.27 to 20.37; p = 0.02) and non-use of antiretroviral therapy (AHR = 12.17; 95% CI = 2.6 to 56.90; p = 0.001) were independently associated with increased risk of tuberculosis.
authors.affiliation: Unidade Mista de Saúde de Brasília, Secretaria de Estado de Saúde do Distrito Federal, Brasília, DF, Brazil.
authors.forename: Leonor Henriette de
authors.initials: LH
authors.lastname: Lannoy
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Cortez-Escalante
authors.forename: Maria do Socorro Nantua
authors.initials: Mdo S
authors.lastname: Evangelista
authors.forename: Gustavo Adolfo Sierra
authors.initials: GA
authors.lastname: Romero
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001938:Brazil / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology*; D019562:Viral Load