title: Survival of a large cohort of HIV-infected tuberculosis patients in the era of highly active antiretroviral treatment.
abstract: OBJECTIVE
  To determine the survival rate, predictive factors and causes of death in a cohort of human immunodeficiency virus (HIV) infected tuberculosis (TB) patients in the era of highly active antiretroviral treatment (HAART).
  
  
  METHODS
  This retrospective cohort study included all HIV-infected TB patients reported in Barcelona between 1996 and 2006. A survival analysis was conducted based on the Kaplan-Meier estimator and Cox proportional hazards; hazard ratios (HRs) and their 95% confidence intervals (CIs) were calculated. Causes of death were classified using the International Classification of Diseases (ICD) 9 and ICD-10, and defined as acquired immune-deficiency syndrome (AIDS) related, non-AIDS-related or unknown.
  
  
  RESULTS
  Of the 792 patients included, 341 (43.1%) died. Survival at 10 years was 47.4% (95%CI 45.2-49.6). Poorer survival was observed in patients aged >30 years (HR 1.6, 95%CI 1.1-2.1), inner-city residents (HR 1.3, 95%CI 1.1-1.7), injecting drug users (HR 1.4, 95%CI 1.1-1.8), those with a non-cavitary radiological pattern (HR 1.5, 95%CI 1.0-2.2), those with <200 CD4/microl (HR 1.8, 95%CI 1.2-2.7) and those diagnosed with AIDS prior to their TB episode (HR 1.85, 95%CI 1.4-2.2). No differences were found for TB treatment (6 vs. 9 months) or for anti-tuberculosis drug resistance; 64.8% of the deaths were non-AIDS-related.
  
  
  CONCLUSIONS
  Poor survival was observed despite the availability of HAART, and non-AIDS-related mortality was high. Earlier HAART could help address AIDS and non-AIDS-related mortality.
authors.affiliation: Epidemiology Service, Public Health Agency of Barcelona, Barcelona, Spain. calmacalmacalma@hotmail.com
authors.forename: L
authors.initials: L
authors.lastname: Català
authors.forename: A
authors.initials: A
authors.lastname: Orcau
authors.forename: P
authors.initials: P
authors.lastname: García de Olalla
authors.forename: J-P
authors.initials: JP
authors.lastname: Millet
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez-Mondragón
authors.forename: J A
authors.initials: JA
authors.lastname: Caylà
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002423:Cause of Death; D016009:Chi-Square Distribution; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality*
chemical_list: D018501:Antirheumatic Agents; D000995:Antitubercular Agents