HIV-associated TB in An Giang Province, Vietnam, 2001-2004: epidemiology and TB treatment outcomes.
BACKGROUND: Mortality is high in HIV-infected TB patients, but few studies from Southeast Asia have documented the benefits of interventions, such as co-trimoxazole (CTX), in reducing mortality during TB treatment. To help guide policy in Vietnam, we studied the epidemiology of HIV-associated TB in...
Main Authors: | , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2007-01-01
|
Series: | PLoS ONE |
Online Access: | http://europepmc.org/articles/PMC1876817?pdf=render |
id |
doaj-580c18137c734091a58911f34c9aaef5 |
---|---|
record_format |
Article |
spelling |
doaj-580c18137c734091a58911f34c9aaef52020-11-25T02:19:49ZengPublic Library of Science (PLoS)PLoS ONE1932-62032007-01-0126e50710.1371/journal.pone.0000507HIV-associated TB in An Giang Province, Vietnam, 2001-2004: epidemiology and TB treatment outcomes.Trinh Thanh ThuyN Sarita ShahMai Hoang AnhDo Trong NghiaDuong ThomTruong LinhDinh Ngoc SyBui Duc DuongLuu Thi Minh ChauPhuong Thi Phoung MaiCharles D WellsKayla F LasersonJay K VarmaBACKGROUND: Mortality is high in HIV-infected TB patients, but few studies from Southeast Asia have documented the benefits of interventions, such as co-trimoxazole (CTX), in reducing mortality during TB treatment. To help guide policy in Vietnam, we studied the epidemiology of HIV-associated TB in one province and examined factors associated with outcomes, including the impact of CTX use. METHODOLOGY/PRINCIPAL FINDINGS: We retrospectively abstracted data for all HIV-infected persons diagnosed with TB from 2001-2004 in An Giang, a province in southern Vietnam in which TB patients receive HIV counseling and testing. We used standard WHO definitions to classify TB treatment outcomes. We conducted multivariate analysis to identify risk factors for the composite outcome of death, default, or treatment failure during TB treatment. From 2001-2004, 637 HIV-infected TB patients were diagnosed in An Giang. Of these, 501 (79%) were male, 321 (50%) were aged 25-34 years, and the most common self-reported HIV risk factor was sex with a commercial sex worker in 221 (35%). TB was classified as smear-positive in 531 (83%). During TB treatment, 167 (26%) patients died, 9 (1%) defaulted, and 6 (1%) failed treatment. Of 454 patients who took CTX, 116 (26%) had an unsuccessful outcome compared with 33 (70%) of 47 patients who did not take CTX (relative risk, 0.4; 95% confidence interval [CI], 0.3-0.5). Adjusting for male sex, rural residence, TB smear status and disease location, and the occurrence of adverse events during TB treatment in multivariate analysis, the benefit of CTX persisted (adjusted odds ratio for unsuccessful outcome 0.1; CI, 0.1-0.3). CONCLUSIONS/SIGNIFICANCE: In An Giang, Vietnam, HIV-associated TB was associated with poor TB treatment outcomes. Outcomes were significantly better in those taking CTX. This finding suggests that Vietnam should consider applying WHO recommendations to prescribe CTX to all HIV-infected TB patients.http://europepmc.org/articles/PMC1876817?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Trinh Thanh Thuy N Sarita Shah Mai Hoang Anh Do Trong Nghia Duong Thom Truong Linh Dinh Ngoc Sy Bui Duc Duong Luu Thi Minh Chau Phuong Thi Phoung Mai Charles D Wells Kayla F Laserson Jay K Varma |
spellingShingle |
Trinh Thanh Thuy N Sarita Shah Mai Hoang Anh Do Trong Nghia Duong Thom Truong Linh Dinh Ngoc Sy Bui Duc Duong Luu Thi Minh Chau Phuong Thi Phoung Mai Charles D Wells Kayla F Laserson Jay K Varma HIV-associated TB in An Giang Province, Vietnam, 2001-2004: epidemiology and TB treatment outcomes. PLoS ONE |
author_facet |
Trinh Thanh Thuy N Sarita Shah Mai Hoang Anh Do Trong Nghia Duong Thom Truong Linh Dinh Ngoc Sy Bui Duc Duong Luu Thi Minh Chau Phuong Thi Phoung Mai Charles D Wells Kayla F Laserson Jay K Varma |
author_sort |
Trinh Thanh Thuy |
title |
HIV-associated TB in An Giang Province, Vietnam, 2001-2004: epidemiology and TB treatment outcomes. |
title_short |
HIV-associated TB in An Giang Province, Vietnam, 2001-2004: epidemiology and TB treatment outcomes. |
title_full |
HIV-associated TB in An Giang Province, Vietnam, 2001-2004: epidemiology and TB treatment outcomes. |
title_fullStr |
HIV-associated TB in An Giang Province, Vietnam, 2001-2004: epidemiology and TB treatment outcomes. |
title_full_unstemmed |
HIV-associated TB in An Giang Province, Vietnam, 2001-2004: epidemiology and TB treatment outcomes. |
title_sort |
hiv-associated tb in an giang province, vietnam, 2001-2004: epidemiology and tb treatment outcomes. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2007-01-01 |
description |
BACKGROUND: Mortality is high in HIV-infected TB patients, but few studies from Southeast Asia have documented the benefits of interventions, such as co-trimoxazole (CTX), in reducing mortality during TB treatment. To help guide policy in Vietnam, we studied the epidemiology of HIV-associated TB in one province and examined factors associated with outcomes, including the impact of CTX use. METHODOLOGY/PRINCIPAL FINDINGS: We retrospectively abstracted data for all HIV-infected persons diagnosed with TB from 2001-2004 in An Giang, a province in southern Vietnam in which TB patients receive HIV counseling and testing. We used standard WHO definitions to classify TB treatment outcomes. We conducted multivariate analysis to identify risk factors for the composite outcome of death, default, or treatment failure during TB treatment. From 2001-2004, 637 HIV-infected TB patients were diagnosed in An Giang. Of these, 501 (79%) were male, 321 (50%) were aged 25-34 years, and the most common self-reported HIV risk factor was sex with a commercial sex worker in 221 (35%). TB was classified as smear-positive in 531 (83%). During TB treatment, 167 (26%) patients died, 9 (1%) defaulted, and 6 (1%) failed treatment. Of 454 patients who took CTX, 116 (26%) had an unsuccessful outcome compared with 33 (70%) of 47 patients who did not take CTX (relative risk, 0.4; 95% confidence interval [CI], 0.3-0.5). Adjusting for male sex, rural residence, TB smear status and disease location, and the occurrence of adverse events during TB treatment in multivariate analysis, the benefit of CTX persisted (adjusted odds ratio for unsuccessful outcome 0.1; CI, 0.1-0.3). CONCLUSIONS/SIGNIFICANCE: In An Giang, Vietnam, HIV-associated TB was associated with poor TB treatment outcomes. Outcomes were significantly better in those taking CTX. This finding suggests that Vietnam should consider applying WHO recommendations to prescribe CTX to all HIV-infected TB patients. |
url |
http://europepmc.org/articles/PMC1876817?pdf=render |
work_keys_str_mv |
AT trinhthanhthuy hivassociatedtbinangiangprovincevietnam20012004epidemiologyandtbtreatmentoutcomes AT nsaritashah hivassociatedtbinangiangprovincevietnam20012004epidemiologyandtbtreatmentoutcomes AT maihoanganh hivassociatedtbinangiangprovincevietnam20012004epidemiologyandtbtreatmentoutcomes AT dotrongnghia hivassociatedtbinangiangprovincevietnam20012004epidemiologyandtbtreatmentoutcomes AT duongthom hivassociatedtbinangiangprovincevietnam20012004epidemiologyandtbtreatmentoutcomes AT truonglinh hivassociatedtbinangiangprovincevietnam20012004epidemiologyandtbtreatmentoutcomes AT dinhngocsy hivassociatedtbinangiangprovincevietnam20012004epidemiologyandtbtreatmentoutcomes AT buiducduong hivassociatedtbinangiangprovincevietnam20012004epidemiologyandtbtreatmentoutcomes AT luuthiminhchau hivassociatedtbinangiangprovincevietnam20012004epidemiologyandtbtreatmentoutcomes AT phuongthiphoungmai hivassociatedtbinangiangprovincevietnam20012004epidemiologyandtbtreatmentoutcomes AT charlesdwells hivassociatedtbinangiangprovincevietnam20012004epidemiologyandtbtreatmentoutcomes AT kaylaflaserson hivassociatedtbinangiangprovincevietnam20012004epidemiologyandtbtreatmentoutcomes AT jaykvarma hivassociatedtbinangiangprovincevietnam20012004epidemiologyandtbtreatmentoutcomes |
_version_ |
1724874209939685376 |