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Tuberculosis and HIV Patient | Predictors for Mortality

Purpose: To identify predictors of mortality for a patient coinfected with HIV and tuberculosis in sub-Saharan Africa based on the study of Mugusi et al.

Description

Mugusi et al identified predictors of mortality in patients coinfected with pulmonary tuberculosis and human immunodeficiency virus (HIV). These can help to identify a patient who may benefit from more aggressive management. The authors are from Muhimbili University of Health and Allied Sciences (Tanzania), Harvard School of Public Health, and the University of Munich.


 

Patient selection: patients in sub-Saharan Africa with coinfected with pulmonary tuberculosis and HIV

 

Predictors of mortality:

(1) older age

(2) Karnofsky performance score < 70%

(3) low CD3 cell count

(4) low CD4 to CD8 ratio

(5) high HIV viral load

(6) oral thrush

 

where:

• Several of these factors suggest clinical AIDS.

 

Additional factors associated with mortality:

(1) anemia (hemoglobin < 12 g/dL for males, < 11 g/dL for females)

(2) not receiving HAART (associated with several predictors)

(3) absence of nausea and vomiting at baseline

(4) no or inadequate therapy of the tuberculosis

 

A patient successfully treated for the tuberculosis is still at high risk for mortality.


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Specialty

Objective

ICD-10