Empirical treatment for TB in HIV: lessons from a cohort study of people living with HIV treated in Recife, Brazil

摘要: Tuberculosis (TB) is the leading cause of death related to HIV worldwide. This study analyzes survival People Living with (PLHIV) reporting cough without bacteriological confirmation TB and identify factors associated death. Prospective cohort a consecutive sample PLHIV, aged ≥ 18 years. Patient inclusion criteria were complaint current any duration at time first interview or during their subsequent routine visits health services for whom AFB sputum smear was either negative not performed whole follow-up period. Kaplan-Meier method used calculate probability survival. We estimated Hazard Ratio (HR) in bivariate multivariate Cox regression analyses. Mortality 4.6 per 100 py; 73% receiving HAART recruitment. Average from recorded date until empirical treatment tuberculosis six months. higher when CD4 count low (HR = 5.3; CI 95%: 3.2-9.0; p = 0.000), those anemia (HR = 3.0; 1.6-5.6; p = 0.001) abnormal chest X-rays (HR = 2.4; 1.4-4.0; p = 0.001). p = 0.002), but only normal X-rays, no history bacteriology requests. Empirical more frequent PLHIV counts, anemia, opportunistic infections, weight loss, previous tuberculosis, test (as opposed having test) X-ray. Higher mortality identified cell <200, X-ray, tuberculosis. significantly empirically treated TB, who had three characteristics suggestive disease (abnormal treatment, M.tb culture testing). Routine cohorts are an adequate setting evaluate impact on PLHIV.