Tuberculosis treatment outcomes of diabetic and non-diabetic TB/HIV co-infected patients: A nationwide observational study in Brazil
BackgroundTuberculosis (TB) is a worldwide public health problem, especially in countries that also report high numbers of people living with HIV (PLWH) and/or diabetes mellitus (DM). However, the unique features of persons with TB-HIV-DM are incompletely understood. This study compared anti-TB trea...
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Frontiers Media S.A.
2022-09-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.972145/full |
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| author | Klauss Villalva-Serra Klauss Villalva-Serra Beatriz Barreto-Duarte Beatriz Barreto-Duarte Beatriz Barreto-Duarte Beatriz Barreto-Duarte Vanessa M. Nunes Vanessa M. Nunes Rodrigo C. Menezes Rodrigo C. Menezes Rodrigo C. Menezes Rodrigo C. Menezes Moreno M. S. Rodrigues Moreno M. S. Rodrigues Artur T. L. Queiroz Artur T. L. Queiroz María B. Arriaga María B. Arriaga María B. Arriaga Marcelo Cordeiro-Santos Marcelo Cordeiro-Santos Marcelo Cordeiro-Santos Afrânio L. Kritski Afrânio L. Kritski Timothy R. Sterling Mariana Araújo-Pereira Mariana Araújo-Pereira Mariana Araújo-Pereira Mariana Araújo-Pereira Bruno B. Andrade Bruno B. Andrade Bruno B. Andrade Bruno B. Andrade Bruno B. Andrade Bruno B. Andrade |
| author_facet | Klauss Villalva-Serra Klauss Villalva-Serra Beatriz Barreto-Duarte Beatriz Barreto-Duarte Beatriz Barreto-Duarte Beatriz Barreto-Duarte Vanessa M. Nunes Vanessa M. Nunes Rodrigo C. Menezes Rodrigo C. Menezes Rodrigo C. Menezes Rodrigo C. Menezes Moreno M. S. Rodrigues Moreno M. S. Rodrigues Artur T. L. Queiroz Artur T. L. Queiroz María B. Arriaga María B. Arriaga María B. Arriaga Marcelo Cordeiro-Santos Marcelo Cordeiro-Santos Marcelo Cordeiro-Santos Afrânio L. Kritski Afrânio L. Kritski Timothy R. Sterling Mariana Araújo-Pereira Mariana Araújo-Pereira Mariana Araújo-Pereira Mariana Araújo-Pereira Bruno B. Andrade Bruno B. Andrade Bruno B. Andrade Bruno B. Andrade Bruno B. Andrade Bruno B. Andrade |
| author_sort | Klauss Villalva-Serra |
| collection | DOAJ |
| description | BackgroundTuberculosis (TB) is a worldwide public health problem, especially in countries that also report high numbers of people living with HIV (PLWH) and/or diabetes mellitus (DM). However, the unique features of persons with TB-HIV-DM are incompletely understood. This study compared anti-TB treatment (ATT) outcomes of diabetic and non-diabetic TB/HIV co-infected patients.MethodsA nationwide retrospective observational investigation was performed with data from the Brazilian Tuberculosis Database System among patients reported to have TB-HIV co-infection between 2014 and 2019. This database includes all reported TB cases in Brazil. Exploratory and association analyses compared TB treatment outcomes in DM and non-DM patients. Unfavorable outcomes were defined as death, treatment failure, loss to follow-up or recurrence. Multivariable stepwise logistic regressions were used to identify the variables associated with unfavorable ATT outcomes in the TB-HIV population.ResultsOf the 31,070 TB-HIV patients analyzed, 999 (3.2%) reported having DM. However, in these TB-HIV patients, DM was not associated with any unfavorable treatment outcome [adjusted Odds Ratio (aOR): 0.97, 95% CI: 0.83–1.12, p = 0.781]. Furthermore, DM was also not associated with any specific type of unfavorable outcome in this study. In both the TB-HIV group and the TB-HIV-DM subpopulation, use of alcohol, illicit drugs and tobacco, as well as non-white ethnicity and prior TB were all characteristics more frequently observed in persons who experienced an unfavorable ATT outcome.ConclusionDM is not associated with unfavorable TB treatment outcomes in persons with TB-HIV, including death, treatment failure, recurrence and loss to follow up. However, consumption habits, non-white ethnicity and prior TB are all more frequently detected in those with unfavorable outcomes in both TB-HIV and TB-HIV-DM patients. |
| first_indexed | 2024-04-11T20:20:15Z |
| format | Article |
| id | doaj.art-86113ae0ee7f4337a93e530787bbd531 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-11T20:20:15Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj.art-86113ae0ee7f4337a93e530787bbd5312022-12-22T04:04:49ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-09-01910.3389/fmed.2022.972145972145Tuberculosis treatment outcomes of diabetic and non-diabetic TB/HIV co-infected patients: A nationwide observational study in BrazilKlauss Villalva-Serra0Klauss Villalva-Serra1Beatriz Barreto-Duarte2Beatriz Barreto-Duarte3Beatriz Barreto-Duarte4Beatriz Barreto-Duarte5Vanessa M. Nunes6Vanessa M. Nunes7Rodrigo C. Menezes8Rodrigo C. Menezes9Rodrigo C. Menezes10Rodrigo C. Menezes11Moreno M. S. Rodrigues12Moreno M. S. Rodrigues13Artur T. L. Queiroz14Artur T. L. Queiroz15María B. Arriaga16María B. Arriaga17María B. Arriaga18Marcelo Cordeiro-Santos19Marcelo Cordeiro-Santos20Marcelo Cordeiro-Santos21Afrânio L. Kritski22Afrânio L. Kritski23Timothy R. Sterling24Mariana Araújo-Pereira25Mariana Araújo-Pereira26Mariana Araújo-Pereira27Mariana Araújo-Pereira28Bruno B. Andrade29Bruno B. Andrade30Bruno B. Andrade31Bruno B. Andrade32Bruno B. Andrade33Bruno B. Andrade34Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, BrazilCurso de Medicina, Universidade Salvador (UNIFACS), Salvador, BrazilMultinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, BrazilPrograma de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, BrazilLaboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BrazilPrograma de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, BrazilMultinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, BrazilCurso de Medicina, Universidade Salvador (UNIFACS), Salvador, BrazilMultinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, BrazilLaboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BrazilFaculdade de Medicina, Universidade Federal da Bahia, Salvador, BrazilGrupo de Estudos em Medicina Intensiva (GEMINI), Salvador, BrazilMultinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, BrazilLaboratório de Análise e Visualização de Dados, Fundação Oswaldo Cruz, Porto Velho, BrazilMultinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, BrazilCenter of Data and Knowledge Integration for Health, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BrazilMultinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, BrazilLaboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil0Instituto de Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, PeruPrograma de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Brazil1Fundação Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil2Faculdade de Medicina, Universidade Nilton Lins, Manaus, BrazilPrograma de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil3Programa Acadêmico de Tuberculose da Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil4Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, United StatesMultinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, BrazilLaboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BrazilFaculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil5Curso de Medicina, Faculdade de Ciência e Tecnologia (UNIFTC), Salvador, BrazilMultinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador, BrazilCurso de Medicina, Universidade Salvador (UNIFACS), Salvador, BrazilLaboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BrazilFaculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil4Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, United States5Curso de Medicina, Faculdade de Ciência e Tecnologia (UNIFTC), Salvador, BrazilBackgroundTuberculosis (TB) is a worldwide public health problem, especially in countries that also report high numbers of people living with HIV (PLWH) and/or diabetes mellitus (DM). However, the unique features of persons with TB-HIV-DM are incompletely understood. This study compared anti-TB treatment (ATT) outcomes of diabetic and non-diabetic TB/HIV co-infected patients.MethodsA nationwide retrospective observational investigation was performed with data from the Brazilian Tuberculosis Database System among patients reported to have TB-HIV co-infection between 2014 and 2019. This database includes all reported TB cases in Brazil. Exploratory and association analyses compared TB treatment outcomes in DM and non-DM patients. Unfavorable outcomes were defined as death, treatment failure, loss to follow-up or recurrence. Multivariable stepwise logistic regressions were used to identify the variables associated with unfavorable ATT outcomes in the TB-HIV population.ResultsOf the 31,070 TB-HIV patients analyzed, 999 (3.2%) reported having DM. However, in these TB-HIV patients, DM was not associated with any unfavorable treatment outcome [adjusted Odds Ratio (aOR): 0.97, 95% CI: 0.83–1.12, p = 0.781]. Furthermore, DM was also not associated with any specific type of unfavorable outcome in this study. In both the TB-HIV group and the TB-HIV-DM subpopulation, use of alcohol, illicit drugs and tobacco, as well as non-white ethnicity and prior TB were all characteristics more frequently observed in persons who experienced an unfavorable ATT outcome.ConclusionDM is not associated with unfavorable TB treatment outcomes in persons with TB-HIV, including death, treatment failure, recurrence and loss to follow up. However, consumption habits, non-white ethnicity and prior TB are all more frequently detected in those with unfavorable outcomes in both TB-HIV and TB-HIV-DM patients.https://www.frontiersin.org/articles/10.3389/fmed.2022.972145/fullHIVtuberculosistreatment outcomediabetesAntiretroviral therapy (ART) |
| spellingShingle | Klauss Villalva-Serra Klauss Villalva-Serra Beatriz Barreto-Duarte Beatriz Barreto-Duarte Beatriz Barreto-Duarte Beatriz Barreto-Duarte Vanessa M. Nunes Vanessa M. Nunes Rodrigo C. Menezes Rodrigo C. Menezes Rodrigo C. Menezes Rodrigo C. Menezes Moreno M. S. Rodrigues Moreno M. S. Rodrigues Artur T. L. Queiroz Artur T. L. Queiroz María B. Arriaga María B. Arriaga María B. Arriaga Marcelo Cordeiro-Santos Marcelo Cordeiro-Santos Marcelo Cordeiro-Santos Afrânio L. Kritski Afrânio L. Kritski Timothy R. Sterling Mariana Araújo-Pereira Mariana Araújo-Pereira Mariana Araújo-Pereira Mariana Araújo-Pereira Bruno B. Andrade Bruno B. Andrade Bruno B. Andrade Bruno B. Andrade Bruno B. Andrade Bruno B. Andrade Tuberculosis treatment outcomes of diabetic and non-diabetic TB/HIV co-infected patients: A nationwide observational study in Brazil Frontiers in Medicine HIV tuberculosis treatment outcome diabetes Antiretroviral therapy (ART) |
| title | Tuberculosis treatment outcomes of diabetic and non-diabetic TB/HIV co-infected patients: A nationwide observational study in Brazil |
| title_full | Tuberculosis treatment outcomes of diabetic and non-diabetic TB/HIV co-infected patients: A nationwide observational study in Brazil |
| title_fullStr | Tuberculosis treatment outcomes of diabetic and non-diabetic TB/HIV co-infected patients: A nationwide observational study in Brazil |
| title_full_unstemmed | Tuberculosis treatment outcomes of diabetic and non-diabetic TB/HIV co-infected patients: A nationwide observational study in Brazil |
| title_short | Tuberculosis treatment outcomes of diabetic and non-diabetic TB/HIV co-infected patients: A nationwide observational study in Brazil |
| title_sort | tuberculosis treatment outcomes of diabetic and non diabetic tb hiv co infected patients a nationwide observational study in brazil |
| topic | HIV tuberculosis treatment outcome diabetes Antiretroviral therapy (ART) |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.972145/full |
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