In-hospital mortality of disseminated tuberculosis in patients infected with the human immunodeficiency virus.
BACKGROUND
Tuberculosis (TB) is a cause of significant morbidity and mortality in patients with AIDS. The goal of our study was to determine predictors of in-hospital mortality in patients with AIDS and disseminated tuberculosis in a middle-income country.


METHODS
We conducted a retrospective cohort study in a tertiary care center, for patients with AIDS in southern Brazil. From 1996 to 2008, all patients with the diagnosis of disseminated TB were included.


RESULTS
Eighty patients were included. In-hospital mortality was 35% (N = 28). On multivariate Cox regression analysis, low basal albumin (P < .01) was associated with death, and fever at admission was related to better survival (P < .01).


CONCLUSIONS
Albumin levels or fever are independent predictors of survival in patients with HIV and disseminated TB. They can serve as indirect markers of immunodeficiency in patients with disseminated TB and AIDS.
dos Santos
Rodrigo Pires
RP
Infectious Disease Service, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, 90035-003 Porto Alegre, RS, Brazil.
Deutschendorf
Caroline
C
Scheid
Karin
K
Goldani
Luciano Zubaran
LZ
D000418:Albumins / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D001938:Brazil; D018450:Disease Progression; D005260:Female; D005334:Fever; D006678:HIV / Q000276:immunology* / Q000472:pathogenicity; D015658:HIV Infections / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000503:physiopathology; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014376:Tuberculosis / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000503:physiopathology
D000418:Albumins; D015415:Biomarkers
Int J Tuberc Lung Dis. 2006 Dec;10(12):1360-6
17167953
MMWR Recomm Rep. 1992 Dec 18;41(RR-17):1-19
1361652
Clin Infect Dis. 1997 May;24(5):988-91
9142808
J Acquir Immune Defic Syndr. 2006 Sep;43(1):42-6
16885778
Arch Intern Med. 1998 Sep 28;158(17):1916-22
9759688
Eur J Epidemiol. 2006;21(9):715-21
17072539
J Clin Microbiol. 1985 Apr;21(4):634-5
3921563
Medicine (Baltimore). 2007 Jan;86(1):39-46
17220754
J Acquir Immune Defic Syndr. 2009 Dec;52(5):623-8
19730270
Chest. 2004 Oct;126(4):1079-86
15486367
J Clin Microbiol. 2003 May;41(5):1987-90
12734238
Int J Tuberc Lung Dis. 2002 Aug;6(8):720-7
12150485
Eur Respir J. 2006 Jun;27(6):1223-8
16481385
AIDS. 2003 Dec 5;17(18):2615-22
14685055
Eur Respir J. 2003 Jul;22(1):141-7
12882464
Lancet. 1999 Oct 2;354(9185):1159-63
10513709
AIDS. 1997 Mar 15;11(4):455-60
9084792
Arch Intern Med. 2008 Jan 14;168(1):86-93
18195200
AIDS. 2007 Sep 12;21(14):1867-75
17721094
Int J Tuberc Lung Dis. 2002 Jan;6(1):64-70
11931403
J Clin Microbiol. 1999 Dec;37(12):4189-91
10565962
Eur J Clin Microbiol Infect Dis. 2002 Apr;21(4):314-7
12072946
Isr Med Assoc J. 2007 Dec;9(12):870-3
18210928
PLoS One. 2007 Sep 05;2(9):e826
17786198
Int J Tuberc Lung Dis. 2003 Dec;7(12):1172-7
14677892
Am J Respir Crit Care Med. 1996 Jan;153(1):317-24
8542137
AIDS. 2003 Jul 25;17(11):1675-82
12853750
J Clin Microbiol. 1986 Nov;24(5):708-11
3095369
J Infect Dis. 2009 Mar 1;199(5):661-5
19199539
Int J Tuberc Lung Dis. 2007 Sep;11(9):1038-41
17918662
Clin Infect Dis. 2005 Dec 15;41(12):1772-82
16288403
Arch Intern Med. 1997 Nov 10;157(20):2359-63
9361577
Age Ageing. 1993 Jul;22(4):289-93
8213336
Respirology. 2007 May;12(3):406-11
17539846
Lancet Infect Dis. 2004 Dec;4(12):739-49
15567123