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Clinical, microbiologic, and immunologic determinants of mortality in hospitalized patients with HIV-associated tuberculosis: A prospective cohort study.

Charlotte SchutzDavid BarrBruno Bezerril AndradeMuki Shehu SheyAmy WardSaskia JanssenRosie BurtonKatalin Andrea WilkinsonBianca SossenKiyoshi F FukutaniMark P NicolGary MaartensRobert John WilkinsonGraeme Meintjes
Published in: PLoS medicine (2019)
In this study, we did not identify a major contribution from coinfections to these deaths. Disseminated tuberculosis, sepsis syndrome, and rifampicin resistance were associated with mortality. An immune profile dominated by mediators of the innate immune system and chemotactic signaling was associated with both tuberculosis dissemination and mortality. These findings provide pathophysiologic insights into underlying causes of mortality and could be used to inform the development of novel treatment strategies and to develop methods to risk stratify patients to appropriately target novel interventions. Causal relationships cannot be established from this study.
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