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 MeintjesPublished 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.
Keyphrases
- mycobacterium tuberculosis
- cardiovascular events
- hiv aids
- pulmonary tuberculosis
- risk factors
- immune response
- end stage renal disease
- newly diagnosed
- ejection fraction
- acute kidney injury
- type diabetes
- coronary artery disease
- human immunodeficiency virus
- antiretroviral therapy
- emergency department
- hiv testing
- peritoneal dialysis
- patient reported outcomes
- septic shock
- men who have sex with men