The complex relationship between human immunodeficiency virus infection and death in adults being treated for tuberculosis in Cape Town, South Africa

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dc.contributor.authorOsman, Muhammaden_ZA
dc.contributor.authorSeddon, James A.en_ZA
dc.contributor.authorDunbar, Roryen_ZA
dc.contributor.authorDraper, Heather R.en_ZA
dc.contributor.authorLombard, Carlen_ZA
dc.contributor.authorBeyers, Nuldaen_ZA
dc.date.accessioned2016-11-11T09:43:10Z
dc.date.available2016-11-11T09:43:10Z
dc.date.issued2015
dc.descriptionCITATION: Osman, M., et al. 2015. The complex relationship between human immunodeficiency virus infection and death in adults being treated for tuberculosis in Cape Town, South Africa. BMC Public Health, 15:556, doi:10.1186/s12889-015-1914-z.
dc.descriptionThe original publication is available at http://bmcpublichealth.biomedcentral.com
dc.description.abstractBackground: Despite recognised treatment strategies, mortality associated with tuberculosis (TB) remains significant. Risk factors for death during TB treatment have been described but the complex relationship between TB and HIV has not been fully understood. Methods: A retrospective analysis of all deaths occurring during TB treatment in Cape Town, South Africa between 2009 and 2012 were done to investigate risk factors associated with this outcome. The main risk factor was HIV status at the start of treatment and its interaction with age, sex and other risk factors were evaluated using a binomial regression model and thus relative risks (RR) are reported. Results: Overall in the 93,133 cases included in the study 4619 deaths (5 %) were recorded. Across all age groups HIV-positive patients were more than twice as likely to die as HIV-negative patients, RR = 2.19 (95 % CI: 2.03–2.37). However in an age specific analysis HIV-positive patients 15–24 and 25–34 years old were at an even higher risk of dying than HIV-negative patients, RR = 4.82 and RR = 3.76 respectively. Gender also modified the effect of HIV- with positive women having a higher risk of death than positive men, RR = 2.74 and RR = 1.94 respectively. Conclusion: HIV carries an increased risk of death in this study but specific high-risk groups pertaining to the impact of HIV are identified. Innovative strategies to manage these high risk groups may contribute to reduction in HIV-associated death in TB patients.en_ZA
dc.description.urihttp://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-1914-z
dc.description.versionPublisher's versionen_ZA
dc.format.extent8 pages
dc.identifier.citationOsman, M., et al. 2015. The complex relationship between human immunodeficiency virus infection and death in adults being treated for tuberculosis in Cape Town, South Africa. BMC Public Health, 15:556, doi:10.1186/s12889-015-1914-z
dc.identifier.issn1471-2458 (online)
dc.identifier.otherdoi:10.1186/s12889-015-1914-z
dc.identifier.urihttp://hdl.handle.net/10019.1/99838
dc.language.isoen_ZAen_ZA
dc.publisherBioMed Central
dc.rights.holderAuthors retain copyright
dc.subjectTuberculosis -- Patients -- Mortalityen_ZA
dc.subjectHIV-positive persons -- Mortality -- South Africa -- Cape Townen_ZA
dc.subjectTuberculosis -- Complicationsen_ZA
dc.subjectHIV infections -- Complicationsen_ZA
dc.titleThe complex relationship between human immunodeficiency virus infection and death in adults being treated for tuberculosis in Cape Town, South Africaen_ZA
dc.typeArticleen_ZA
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