HIV infection is associated with a lower incidence of constriction in presumed tuberculous pericarditis : a prospective observational study

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dc.contributor.authorNtsekhe, Mpiko
dc.contributor.authorWiysonge, Charles S.
dc.contributor.authorGumedze, Freedom
dc.contributor.authorMaartens, Gary
dc.contributor.authorCommerford, Patrick J.
dc.contributor.authorVolmink, Jimmy A.
dc.contributor.authorMayosi, Bongani M.
dc.date.accessioned2011-05-15T16:00:17Z
dc.date.available2011-05-15T16:00:17Z
dc.date.issued2008-04
dc.descriptionThe original publication is available at http:/www.plosone.orgen_ZA
dc.description.abstractBackground: Pericardial constriction is a serious complication of tuberculous pericardial effusion that occurs in up to a quarter of patients despite anti-tuberculosis chemotheraphy. The impact of human immunodeficiency virus (HIV) infection on the incidence of constrictive pericarditis following tuberculous pericardial effusion is unknown. Methods and Results: We conducted a prospective observational study to determine the association between HIV infection and the incidence of constrictive pericarditis among 185 patients (median age 33 years) with suspected tuberculous pericardial effusion. These patients were recruited consecutively between March and October 2004 on commencement of anti-tuberculosis treatment, from 15 hospitals in Cameroon, Nigeria and South Africa. Surviving patients (N = 119) were assessed for clinical evidence of constrictive pericarditis at 3 and 6 months of follow-up. Clinical features of HIV infection were present in 42 (35.2%) of the 119 patients at enrolment into the study.66 of the 119 (56.9%) patients consented to HIV testing at enrolment. During the 6 months of follow-up, a clinical diagnosis of constrictive pericarditis was made in 13 of the 119 patients (10.9%, 95% confidence interval [CI] 5.9-18%). Patients with clinical features of HIV infection appear less likely to develop constriction than those without (4.8% versus 14.3%; P = 0.08). None of the 33 HIV seropositive patients developed constriction, but 8 (24.2%, 95%CI 11.1-42.3%)of the 33 HIV seronegative patients did (P = 0.005). In a multivariate logistic regression model adjusting simultaneously for several baseline characteristics, only clinical signs of HIV infection were significantly associated with a lower risk of constriction (odd ratio 0.14, 95% CI 0.02-0.87, P = 0.035). Conclusions: These data suggest that HIV infection is associated with a lower incidence of pericardial constriction in patients with presumed tuberculous pericarditis. © 2008 Ntsekhe et al.en_ZA
dc.description.sponsorshipThis study was funded, in part, through research grants from the University of Cape Town, the Medical Scholarships for South African Blacks (MESAB), the Medical Research Council of South Africa, the National Research Foundation of South Africa.en_ZA
dc.description.versionPublishers' version
dc.format.extent5 p. : ill.
dc.identifier.citationNtsekhe, M. et al. 2008. HIV Infection Is Associated with a Lower Incidence of Constriction in Presumed Tuberculous Pericarditis: A Prospective Observational Study. PLoS ONE, 3(6): e2253, doi:10.1371/journal.pone.0002253.en_ZA
dc.identifier.issn1932-6203 (online)
dc.identifier.otherdoi:10.1371/journal.pone.0002253
dc.identifier.urihttp://hdl.handle.net/10019.1/11617
dc.language.isoen_ZA
dc.publisherPublic Library of Science (PLOS)
dc.rights.holderAuthors retain copyright
dc.subjectTuberculous pericarditis effusion -- Cameroon
dc.subjectHIV positive persons -- Effect of pericardial effusion on-en_ZA
dc.subjectTuberculous pericarditis effusion -- South Africaen_ZA
dc.subjectTuberculous pericarditis effusion -- Zimbabween_ZA
dc.subjectHIV Infectionsen_ZA
dc.subjectPericarditis, Tuberculousen_ZA
dc.subjectPericardial effusionen_ZA
dc.subjectTuberculous pericarditis -- Diagnosisen_ZA
dc.subjectPericardial effusion -- Diagnosisen_ZA
dc.subjectPericarditis -- Effect of HIV infections 0n -en_ZA
dc.subjectTuberculous pericarditis effusion -- Nigeriaen_+ZA
dc.titleHIV infection is associated with a lower incidence of constriction in presumed tuberculous pericarditis : a prospective observational studyen_ZA
dc.typeArticleen_ZA
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