CHARACTERISTICS OF HIV-INFECTED TUBERCULOSIS PATIENTS IN THAILAND
To improve understanding about the epidemiology and clinical features of HIV-associated tuberculosis (TB) infection we conducted a prospective, multi-center observational study of HIV-infected TB patients in Thailand. We enrolled HIV-infected patients diagnosed with TB at public health facilities fr...
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| Veröffentlicht in: | Southeast Asian journal of tropical medicine and public health 2009, Vol.40 (1), p.93-103 |
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| creator | MANKATITTHAM, Wiroj LIKANONSAKUL, Sirirat TASANEEYAPAN, Theerawit VARMA, Jay K THAWORNWAN, Unchana KONGSANAN, Paweena KITTIKRAISAK, Wanitchaya BURAPAT, Channawong AKKSILP, Somsak SATTAYAWUTHIPONG, Wanchai SRINAK, Chawin NATENIYOM, Sriprapa |
| description | To improve understanding about the epidemiology and clinical features of HIV-associated tuberculosis (TB) infection we conducted a prospective, multi-center observational study of HIV-infected TB patients in Thailand. We enrolled HIV-infected patients diagnosed with TB at public health facilities from three provinces and the national infectious diseases referral hospital in Thailand. Patients underwent standardized interviews, evaluations, and laboratory testing at the beginning of TB treatment. We analyzed demographic and clinical characteristics of patients and stratified our findings by level of immune-suppression and whether antiretroviral therapy (ART) was used before TB diagnosis. Of 769 patients analyzed, pulmonary TB was diagnosed in 461 (60%). The median CD4+ T-lymphocyte (CD4) count was 63 cells/microl [interquartile range (IQR), 23-163.5] and the median HIV RNA viral load was 308,000 copies/ml (IQR, 51,900-759,000) at the time of TB diagnosis. Methamphetamine use was reported by 304 patients (40%), marijuana by 267 patients (35%), and injection drug use by 199 patients (26%). Three hundred three patients (40%) reported having been previously incarcerated. Among sexually active patients, 142 (42%) reported never using condoms at all. Patients with CD4 counts or =200 cells/microl to have extra-pulmonary TB, fever, fatigue, muscle weakness, no hemoptysis, tachycardia, low body mass index, jaundice, or no pleural effusion. Of the 94 patients that received ART before TB diagnosis, the median time from ART initiation to TB diagnosis was 105 days (IQR, 31-468). HIV-infected patients who developed TB after ART initiation were more likely than other HIV-infected TB patients to have extra-pulmonary TB, a normal chest radiograph, low HIV RNA viral load, or a history of previous TB treatment. |
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We enrolled HIV-infected patients diagnosed with TB at public health facilities from three provinces and the national infectious diseases referral hospital in Thailand. Patients underwent standardized interviews, evaluations, and laboratory testing at the beginning of TB treatment. We analyzed demographic and clinical characteristics of patients and stratified our findings by level of immune-suppression and whether antiretroviral therapy (ART) was used before TB diagnosis. Of 769 patients analyzed, pulmonary TB was diagnosed in 461 (60%). The median CD4+ T-lymphocyte (CD4) count was 63 cells/microl [interquartile range (IQR), 23-163.5] and the median HIV RNA viral load was 308,000 copies/ml (IQR, 51,900-759,000) at the time of TB diagnosis. Methamphetamine use was reported by 304 patients (40%), marijuana by 267 patients (35%), and injection drug use by 199 patients (26%). Three hundred three patients (40%) reported having been previously incarcerated. Among sexually active patients, 142 (42%) reported never using condoms at all. Patients with CD4 counts <200 cells/microl were significantly more likely than patients with CD4 counts > or =200 cells/microl to have extra-pulmonary TB, fever, fatigue, muscle weakness, no hemoptysis, tachycardia, low body mass index, jaundice, or no pleural effusion. Of the 94 patients that received ART before TB diagnosis, the median time from ART initiation to TB diagnosis was 105 days (IQR, 31-468). HIV-infected patients who developed TB after ART initiation were more likely than other HIV-infected TB patients to have extra-pulmonary TB, a normal chest radiograph, low HIV RNA viral load, or a history of previous TB treatment.</description><identifier>ISSN: 0125-1562</identifier><identifier>PMID: 19323040</identifier><identifier>CODEN: SJTMAK</identifier><language>eng</language><publisher>Bangkok: SEAMO, Regional Tropical Medicine and Public Health Network</publisher><subject>Adult ; AIDS-Related Opportunistic Infections - complications ; AIDS-Related Opportunistic Infections - epidemiology ; AIDS-Related Opportunistic Infections - microbiology ; Anti-HIV Agents - adverse effects ; Anti-HIV Agents - therapeutic use ; Antitubercular Agents - adverse effects ; Antitubercular Agents - therapeutic use ; Bacterial diseases ; Biological and medical sciences ; CD4-Positive T-Lymphocytes ; Female ; General aspects ; HIV Infections - complications ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV Infections - virology ; HIV-1 ; Human bacterial diseases ; Human viral diseases ; Humans ; Immunocompromised Host ; Infectious diseases ; Male ; Medical sciences ; Middle Aged ; Observation ; Prospective Studies ; Risk Factors ; RNA, Viral ; Thailand - epidemiology ; Treatment Outcome ; Tuberculosis and atypical mycobacterial infections ; Tuberculosis, Pulmonary - complications ; Tuberculosis, Pulmonary - drug therapy ; Tuberculosis, Pulmonary - epidemiology ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Young Adult</subject><ispartof>Southeast Asian journal of tropical medicine and public health, 2009, Vol.40 (1), p.93-103</ispartof><rights>2009 INIST-CNRS</rights><rights>Copyright Central Coordinating Board, SEAMEO-TROPMED Project Jan 2009</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21283998$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19323040$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MANKATITTHAM, Wiroj</creatorcontrib><creatorcontrib>LIKANONSAKUL, Sirirat</creatorcontrib><creatorcontrib>TASANEEYAPAN, Theerawit</creatorcontrib><creatorcontrib>VARMA, Jay K</creatorcontrib><creatorcontrib>THAWORNWAN, Unchana</creatorcontrib><creatorcontrib>KONGSANAN, Paweena</creatorcontrib><creatorcontrib>KITTIKRAISAK, Wanitchaya</creatorcontrib><creatorcontrib>BURAPAT, Channawong</creatorcontrib><creatorcontrib>AKKSILP, Somsak</creatorcontrib><creatorcontrib>SATTAYAWUTHIPONG, Wanchai</creatorcontrib><creatorcontrib>SRINAK, Chawin</creatorcontrib><creatorcontrib>NATENIYOM, Sriprapa</creatorcontrib><title>CHARACTERISTICS OF HIV-INFECTED TUBERCULOSIS PATIENTS IN THAILAND</title><title>Southeast Asian journal of tropical medicine and public health</title><addtitle>Southeast Asian J Trop Med Public Health</addtitle><description>To improve understanding about the epidemiology and clinical features of HIV-associated tuberculosis (TB) infection we conducted a prospective, multi-center observational study of HIV-infected TB patients in Thailand. We enrolled HIV-infected patients diagnosed with TB at public health facilities from three provinces and the national infectious diseases referral hospital in Thailand. Patients underwent standardized interviews, evaluations, and laboratory testing at the beginning of TB treatment. We analyzed demographic and clinical characteristics of patients and stratified our findings by level of immune-suppression and whether antiretroviral therapy (ART) was used before TB diagnosis. Of 769 patients analyzed, pulmonary TB was diagnosed in 461 (60%). The median CD4+ T-lymphocyte (CD4) count was 63 cells/microl [interquartile range (IQR), 23-163.5] and the median HIV RNA viral load was 308,000 copies/ml (IQR, 51,900-759,000) at the time of TB diagnosis. Methamphetamine use was reported by 304 patients (40%), marijuana by 267 patients (35%), and injection drug use by 199 patients (26%). Three hundred three patients (40%) reported having been previously incarcerated. Among sexually active patients, 142 (42%) reported never using condoms at all. Patients with CD4 counts <200 cells/microl were significantly more likely than patients with CD4 counts > or =200 cells/microl to have extra-pulmonary TB, fever, fatigue, muscle weakness, no hemoptysis, tachycardia, low body mass index, jaundice, or no pleural effusion. Of the 94 patients that received ART before TB diagnosis, the median time from ART initiation to TB diagnosis was 105 days (IQR, 31-468). HIV-infected patients who developed TB after ART initiation were more likely than other HIV-infected TB patients to have extra-pulmonary TB, a normal chest radiograph, low HIV RNA viral load, or a history of previous TB treatment.</description><subject>Adult</subject><subject>AIDS-Related Opportunistic Infections - complications</subject><subject>AIDS-Related Opportunistic Infections - epidemiology</subject><subject>AIDS-Related Opportunistic Infections - microbiology</subject><subject>Anti-HIV Agents - adverse effects</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antitubercular Agents - adverse effects</subject><subject>Antitubercular Agents - therapeutic use</subject><subject>Bacterial diseases</subject><subject>Biological and medical sciences</subject><subject>CD4-Positive T-Lymphocytes</subject><subject>Female</subject><subject>General aspects</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - virology</subject><subject>HIV-1</subject><subject>Human bacterial diseases</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunocompromised Host</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Observation</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>RNA, Viral</subject><subject>Thailand - epidemiology</subject><subject>Treatment Outcome</subject><subject>Tuberculosis and atypical mycobacterial infections</subject><subject>Tuberculosis, Pulmonary - complications</subject><subject>Tuberculosis, Pulmonary - drug therapy</subject><subject>Tuberculosis, Pulmonary - epidemiology</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Young Adult</subject><issn>0125-1562</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNo9z11rgzAUBuBcbKxdt78wZLBLITmJmlxm1taA2KFxtxI1gZZ-OK0X-_cT1u3qcF4ezsu5Q0tMIPBJEMICPY7jAWOGieAPaEEEBTpvSyTjVBYy1kmhSq3i0tttvFR9-irfJHO69nT1nhRxle1KVXofUqsk16Wnck-nUmUyXz-he2eOo32-zRWqNomOUz_bbVUsM7-HMLz6NmDMQSeEdR3lBkTnIkZEE5kWG0uts1HThRZY0zrOmAFLXWcIZRCEHGxAV-j1924_XL4mO17rw2UaznNlDZiwCPOAzOjlhqbmZLu6H_YnM3zXfw_P4O0GzNiaoxvMud2P_w4IcCoEpz9YJVcu</recordid><startdate>2009</startdate><enddate>2009</enddate><creator>MANKATITTHAM, Wiroj</creator><creator>LIKANONSAKUL, Sirirat</creator><creator>TASANEEYAPAN, Theerawit</creator><creator>VARMA, Jay K</creator><creator>THAWORNWAN, Unchana</creator><creator>KONGSANAN, Paweena</creator><creator>KITTIKRAISAK, Wanitchaya</creator><creator>BURAPAT, Channawong</creator><creator>AKKSILP, Somsak</creator><creator>SATTAYAWUTHIPONG, Wanchai</creator><creator>SRINAK, Chawin</creator><creator>NATENIYOM, Sriprapa</creator><general>SEAMO, Regional Tropical Medicine and Public Health Network</general><general>Central Coordinating Board, SEAMEO-TROPMED Project</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>3V.</scope><scope>7QL</scope><scope>7SS</scope><scope>7T7</scope><scope>7U7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BVBZV</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>P64</scope><scope>PATMY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PYCSY</scope></search><sort><creationdate>2009</creationdate><title>CHARACTERISTICS OF HIV-INFECTED TUBERCULOSIS PATIENTS IN THAILAND</title><author>MANKATITTHAM, Wiroj ; LIKANONSAKUL, Sirirat ; TASANEEYAPAN, Theerawit ; VARMA, Jay K ; THAWORNWAN, Unchana ; KONGSANAN, Paweena ; KITTIKRAISAK, Wanitchaya ; BURAPAT, Channawong ; AKKSILP, Somsak ; SATTAYAWUTHIPONG, Wanchai ; SRINAK, Chawin ; NATENIYOM, Sriprapa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p266t-e544f2d99efd38a29df7419b7ac0ae3efe7bd6e24bcf844a2e3fda13425682e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>AIDS-Related Opportunistic Infections - complications</topic><topic>AIDS-Related Opportunistic Infections - epidemiology</topic><topic>AIDS-Related Opportunistic Infections - microbiology</topic><topic>Anti-HIV Agents - adverse effects</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antitubercular Agents - adverse effects</topic><topic>Antitubercular Agents - therapeutic use</topic><topic>Bacterial diseases</topic><topic>Biological and medical sciences</topic><topic>CD4-Positive T-Lymphocytes</topic><topic>Female</topic><topic>General aspects</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - epidemiology</topic><topic>HIV Infections - virology</topic><topic>HIV-1</topic><topic>Human bacterial diseases</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunocompromised Host</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Observation</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>RNA, Viral</topic><topic>Thailand - epidemiology</topic><topic>Treatment Outcome</topic><topic>Tuberculosis and atypical mycobacterial infections</topic><topic>Tuberculosis, Pulmonary - complications</topic><topic>Tuberculosis, Pulmonary - drug therapy</topic><topic>Tuberculosis, Pulmonary - epidemiology</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Young Adult</topic><toplevel>online_resources</toplevel><creatorcontrib>MANKATITTHAM, Wiroj</creatorcontrib><creatorcontrib>LIKANONSAKUL, Sirirat</creatorcontrib><creatorcontrib>TASANEEYAPAN, Theerawit</creatorcontrib><creatorcontrib>VARMA, Jay K</creatorcontrib><creatorcontrib>THAWORNWAN, Unchana</creatorcontrib><creatorcontrib>KONGSANAN, Paweena</creatorcontrib><creatorcontrib>KITTIKRAISAK, Wanitchaya</creatorcontrib><creatorcontrib>BURAPAT, Channawong</creatorcontrib><creatorcontrib>AKKSILP, Somsak</creatorcontrib><creatorcontrib>SATTAYAWUTHIPONG, Wanchai</creatorcontrib><creatorcontrib>SRINAK, Chawin</creatorcontrib><creatorcontrib>NATENIYOM, Sriprapa</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>East & South Asia Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Environmental Science Collection</collection><jtitle>Southeast Asian journal of tropical medicine and public health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MANKATITTHAM, Wiroj</au><au>LIKANONSAKUL, Sirirat</au><au>TASANEEYAPAN, Theerawit</au><au>VARMA, Jay K</au><au>THAWORNWAN, Unchana</au><au>KONGSANAN, Paweena</au><au>KITTIKRAISAK, Wanitchaya</au><au>BURAPAT, Channawong</au><au>AKKSILP, Somsak</au><au>SATTAYAWUTHIPONG, Wanchai</au><au>SRINAK, Chawin</au><au>NATENIYOM, Sriprapa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>CHARACTERISTICS OF HIV-INFECTED TUBERCULOSIS PATIENTS IN THAILAND</atitle><jtitle>Southeast Asian journal of tropical medicine and public health</jtitle><addtitle>Southeast Asian J Trop Med Public Health</addtitle><date>2009</date><risdate>2009</risdate><volume>40</volume><issue>1</issue><spage>93</spage><epage>103</epage><pages>93-103</pages><issn>0125-1562</issn><coden>SJTMAK</coden><abstract>To improve understanding about the epidemiology and clinical features of HIV-associated tuberculosis (TB) infection we conducted a prospective, multi-center observational study of HIV-infected TB patients in Thailand. We enrolled HIV-infected patients diagnosed with TB at public health facilities from three provinces and the national infectious diseases referral hospital in Thailand. Patients underwent standardized interviews, evaluations, and laboratory testing at the beginning of TB treatment. We analyzed demographic and clinical characteristics of patients and stratified our findings by level of immune-suppression and whether antiretroviral therapy (ART) was used before TB diagnosis. Of 769 patients analyzed, pulmonary TB was diagnosed in 461 (60%). The median CD4+ T-lymphocyte (CD4) count was 63 cells/microl [interquartile range (IQR), 23-163.5] and the median HIV RNA viral load was 308,000 copies/ml (IQR, 51,900-759,000) at the time of TB diagnosis. Methamphetamine use was reported by 304 patients (40%), marijuana by 267 patients (35%), and injection drug use by 199 patients (26%). Three hundred three patients (40%) reported having been previously incarcerated. Among sexually active patients, 142 (42%) reported never using condoms at all. Patients with CD4 counts <200 cells/microl were significantly more likely than patients with CD4 counts > or =200 cells/microl to have extra-pulmonary TB, fever, fatigue, muscle weakness, no hemoptysis, tachycardia, low body mass index, jaundice, or no pleural effusion. Of the 94 patients that received ART before TB diagnosis, the median time from ART initiation to TB diagnosis was 105 days (IQR, 31-468). HIV-infected patients who developed TB after ART initiation were more likely than other HIV-infected TB patients to have extra-pulmonary TB, a normal chest radiograph, low HIV RNA viral load, or a history of previous TB treatment.</abstract><cop>Bangkok</cop><pub>SEAMO, Regional Tropical Medicine and Public Health Network</pub><pmid>19323040</pmid><tpages>11</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0125-1562 |
| ispartof | Southeast Asian journal of tropical medicine and public health, 2009, Vol.40 (1), p.93-103 |
| issn | 0125-1562 |
| language | eng |
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| subjects | Adult AIDS-Related Opportunistic Infections - complications AIDS-Related Opportunistic Infections - epidemiology AIDS-Related Opportunistic Infections - microbiology Anti-HIV Agents - adverse effects Anti-HIV Agents - therapeutic use Antitubercular Agents - adverse effects Antitubercular Agents - therapeutic use Bacterial diseases Biological and medical sciences CD4-Positive T-Lymphocytes Female General aspects HIV Infections - complications HIV Infections - drug therapy HIV Infections - epidemiology HIV Infections - virology HIV-1 Human bacterial diseases Human viral diseases Humans Immunocompromised Host Infectious diseases Male Medical sciences Middle Aged Observation Prospective Studies Risk Factors RNA, Viral Thailand - epidemiology Treatment Outcome Tuberculosis and atypical mycobacterial infections Tuberculosis, Pulmonary - complications Tuberculosis, Pulmonary - drug therapy Tuberculosis, Pulmonary - epidemiology Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Young Adult |
| title | CHARACTERISTICS OF HIV-INFECTED TUBERCULOSIS PATIENTS IN THAILAND |
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