| Health care index score and risk of death following tuberculosis diagnosis in HIV-positive patients. | |
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MedLine Citation:
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PMID: 23317955 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVES: To assess health care utilisation for patients co-infected with TB and HIV (TB-HIV), and to develop a weighted health care index (HCI) score based on commonly used interventions and compare it with patient outcome. METHODS: A total of 1061 HIV patients diagnosed with TB in four regions, Central/Northern, Southern and Eastern Europe and Argentina, between January 2004 and December 2006 were enrolled in the TB-HIV study. A weighted HCI score (range 0-5), based on independent prognostic factors identified in multivariable Cox models and the final score, included performance of TB drug susceptibility testing (DST), an initial TB regimen containing a rifamycin, isoniazid and pyrazinamide, and start of combination antiretroviral treatment (cART). RESULTS: The mean HCI score was highest in Central/Northern Europe (3.2, 95%CI 3.1-3.3) and lowest in Eastern Europe (1.6, 95%CI 1.5-1.7). The cumulative probability of death 1 year after TB diagnosis decreased from 39% (95%CI 31-48) among patients with an HCI score of 0, to 9% (95%CI 6-13) among those with a score of ≥4. In an adjusted Cox model, a 1-unit increase in the HCI score was associated with 27% reduced mortality (relative hazard 0.73, 95%CI 0.64-0.84). CONCLUSIONS: Our results suggest that DST, standard anti-tuberculosis treatment and early cART may improve outcome for TB-HIV patients. The proposed HCI score provides a tool for future research and monitoring of the management of TB-HIV patients. The highest HCI score may serve as a benchmark to assess TB-HIV management, encouraging continuous health care improvement. |
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Authors:
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D N Podlekareva; D Grint; F A Post; A Mocroft; A M Panteleev; R F Miller; J M Miro; M Bruyand; H Furrer; V Riekstina; E Girardi; M H Losso; J A Caylá; E A Malashenkov; N Obel; A M Skrahina; J D Lundgren; O Kirk; |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease Volume: 17 ISSN: 1815-7920 ISO Abbreviation: Int. J. Tuberc. Lung Dis. Publication Date: 2013 Feb |
Date Detail:
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Created Date: 2013-01-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9706389 Medline TA: Int J Tuberc Lung Dis Country: France |
Other Details:
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Languages: eng Pagination: 198-206 Citation Subset: IM |
Affiliation:
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Copenhagen HIV Programme, University of Copenhagen, Denmark. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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