Tuberculosis in HIV-negative and HIV-infected patients in a low-incidence country: clinical characteristics and treatment outcomes.

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Serval ID
serval:BIB_188C52E252E0
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Tuberculosis in HIV-negative and HIV-infected patients in a low-incidence country: clinical characteristics and treatment outcomes.
Journal
Plos One
Author(s)
Fenner L., Gagneux S., Janssens J.P., Fehr J., Cavassini M., Hoffmann M., Bernasconi E., Schrenzel J., Bodmer T., Böttger E.C., Helbling P., Egger M.
Working group(s)
Swiss HIV Cohort, Molecular Epidemiology of Tuberculosis Study Groups
Contributor(s)
Fenner L., Egger M., Gagneux S., Tanner M., Furrer H., Böttger EC., Frei R., Bodmer T., Ninet B., Schrenzel J., Jaton K., Telenti A., Siegrist H., Pfyffer GE., Bruderer T., Dolina M., Dubuis O., Battegay M., Bernasconi E., Hoffmann M., Furrer H., Cavassini M., Hirschel B., Calmy A., Fehr J., Janssens JP., Stalder JM., Helbling P., Altpeter E., Rieder HL., Barth J., Battegay M., Bernasconi E., Böni J., Bucher HC., Burton-Jeangros C., Calmy A., Cavassini M., Cellerai C., Egger M., Elzi L., Fehr J., Fellay J., Flepp M., Francioli P., Furrer H., Fux CA., Gorgievski M., Günthard H., Haerry D., Hasse B., Hirsch HH., Hirschel B., Hösli I., Kahlert C., Kaiser L., Keiser O., Kind C., Klimkait T., Kovari H., Ledergerber B., Martinetti G., Martinez de Tejada B., Metzner K., Müller N., Nadal D., Pantaleo G., Rauch A., Regenass S., Rickenbach M., Rudin C., Schmid P., Schultze D., Schöni-Affolter F., Schüpbach J., Speck R., Taffé P., Tarr P., Telenti A., Trkola A., Vernazza P., Weber R., Yerly S.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2012
Volume
7
Number
3
Pages
e34186
Language
english
Notes
Publication types: Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Abstract
BACKGROUND: In Switzerland and other developed countries, the number of tuberculosis (TB) cases has been decreasing for decades, but HIV-infected patients and migrants remain risk groups. The aim of this study was to compare characteristics of TB in HIV-negative and HIV-infected patients diagnosed in Switzerland, and between coinfected patients enrolled and not enrolled in the national Swiss HIV Cohort Study (SHCS).
METHODS AND FINDINGS: All patients diagnosed with culture-confirmed TB in the SHCS and a random sample of culture-confirmed cases reported to the national TB registry 2000-2008 were included. Outcomes were assessed in HIV-infected patients and considered successful in case of cure or treatment completion. Ninety-three SHCS patients and 288 patients selected randomly from 4221 registered patients were analyzed. The registry sample included 10 (3.5%) coinfected patients not enrolled in the SHCS: the estimated number of HIV-infected patients not enrolled in the SHCS but reported to the registry 2000-2008 was 146 (95% CI 122-173). Coinfected patients were more likely to be from sub-Saharan Africa (51.5% versus 15.8%, P<0.0001) and to present disseminated disease (23.9% vs. 3.4%, P<0.0001) than HIV-negative patients. Coinfected patients not enrolled in the SHCS were asylum seekers or migrant workers, with lower CD4 cell counts at TB diagnosis (median CD4 count 79 cells/µL compared to 149 cells/µL among SHCS patients, P = 0.07). There were 6 patients (60.0%) with successful outcomes compared to 82 (88.2%) patients in the SHCS (P = 0.023).
CONCLUSIONS: The clinical presentation of coinfected patients differed from HIV-negative TB patients. The number of HIV-infected patients diagnosed with TB outside the SHCS is similar to the number diagnosed within the cohort but outcomes are poorer in patients not followed up in the national cohort. Special efforts are required to address the needs of this vulnerable population.
Keywords
Adult, CD4-Positive T-Lymphocytes/cytology, Cohort Studies, Comorbidity, Female, HIV Infections/complications, HIV Infections/epidemiology, HIV Seropositivity, Humans, Incidence, Male, Middle Aged, Prospective Studies, Risk, Switzerland, Transients and Migrants, Treatment Outcome, Tuberculosis/complications, Tuberculosis/epidemiology
Pubmed
Web of science
Open Access
Yes
Create date
22/07/2012 21:29
Last modification date
20/08/2019 12:49
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