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1996-02-27
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Document 0193
DOCN M9630193
TI Does the onset of tuberculosis in AIDS predict shorter survival? Results
of a cohort study in 17 European countries over 13 years. AIDS in Europe
Study Group.
DT 9603
AU Perneger TV; Sudre P; Lundgren JD; Hirschel B; Institute of Social and
Preventive Medicine, University of; Geneva, Switzerland.
SO BMJ. 1995 Dec 2;311(7018):1468-71. Unique Identifier : AIDSLINE
MED/96096391
AB OBJECTIVE--To assess the impact of tuberculosis on mortality in patients
with AIDS. DESIGN--Community based cohort study. SETTING--52 centres in
17 countries (AIDS in Europe study). SUBJECTS--5249 patients who were
alive and free of tuberculosis one month after the diagnosis of AIDS,
enrolled between 1979 and 1989, and followed up until 1992. MAIN OUTCOME
MEASURES--Onset of clinically active tuberculosis or death, or both.
RESULTS--During a mean follow up period of 15 months 201 (4%) patients
developed tuberculosis and 3889 (74%) died. Patients who developed
tuberculosis survived significantly longer (median 22 months) than those
who did not (median 16 months). This apparent survival advantage was due
to patients who survived longer having more opportunity to develop
tuberculosis (or any other disease). In models that took into account
the time at which tuberculosis was diagnosed, the onset of tuberculosis
was associated with a significant increase in mortality (adjusted
relative hazard of death 1.34; 95% confidence interval 1.12 to 1.60).
CONCLUSIONS--The onset of tuberculosis in patients with AIDS predicts a
substantial increase in mortality. Whether this increased mortality is
directly attributable to the tuberculosis remains uncertain. If the
association is causal preventive chemotherapy and aggressive treatment
of tuberculosis could improve survival in AIDS.
DE Acquired Immunodeficiency Syndrome/*MORTALITY Adult Aged AIDS-Related
Opportunistic Infections/*MORTALITY Cohort Studies Europe/EPIDEMIOLOGY
Female Follow-Up Studies Human Male Middle Age Prospective Studies
Support, Non-U.S. Gov't Survival Analysis Survival Rate
Tuberculosis/*MORTALITY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).