title: Mycobacterium tuberculosis and human immunodeficiency virus coinfection in a tertiary care hospital in Midwestern Brazil.
abstract: Infection with human immunodeficiency virus (HIV) increases the risk of tuberculosis (TB), and HIV TB coinfection is associated with higher mortality. This study aimed to characterize patients coinfected with Mycobacterium tuberculosis and HIV in a reference centre for cases involving complications or drug resistance in TB. This retrospective cohort study was conducted at a Hospital for Tropical Diseases in the state of Goiás, Midwestern Brazil. Patients' medical records were reviewed between January 2008 and December 2009. Sixty-one cases of TB/HIV coinfection were evaluated, and 54 HIV-seronegative TB cases were selected as controls. The prevalence of TB HIV coinfected patients in 2008/2009 was 23%. Coinfection was more prevalent in men (75.4%), with a mean age of 37.1 years. Pulmonary disease (50.8%) was the most frequent clinical form of TB in coinfected patients, followed by disseminated disease (32.8%). Anaemia, malnutrition and low levels of CD4 T lymphocytes were found in about 80% of coinfected patients. Bilateral pulmonary infiltrates were the most common radiographic finding in coinfected patients (51.8%), and pulmonary cavitation was the rarest event (5.4%). The mortality rate was 2.8 times higher in the TB HIV coinfected group (39.3%) than in TB patients without HIV (18.5%). Actions targeting the TB HIV-coinfected population, based on national and international recommendations, are necessary to improve prognosis and outcomes in TB and HIV infection in the institution.
authors: Tropical Pathology and Public Health Institute, Universidade Federal de Goiás, Goiânia, GO, Brazil.
authors: Tatiana Bacelar Acioli
authors: TB
authors: Lins
authors: Eldom de Medeiros
authors: Ede M
authors: Soares
authors: Felipe Macedo
authors: FM
authors: dos Santos
authors: Polyana Maria Pimenta
authors: PM
authors: Mandacaru
authors: Tatiana
authors: T
authors: Pina
authors: João Alves
authors: JA
authors: de Araújo Filho
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000821:virology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification; D010352:Patient Dropouts / Q000706:statistics & numerical data; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000821:virology; D011859:Radiography; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014376:Tuberculosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents