Original Articles
Effects of HIV Status and Other Variables on the Outcome of Tuberculosis Treatment in Spain
M. Díez Ruiz-Navarro
, J.A. Hernández Espinosa, M.J. Bleda Hernández, A. Díaz Franco, C. Castells Carrillo, A. Domínguez García, A.M. García Fulgueiras, P. Gayoso Diz, M.J. López de Valdivielso, M.F. Vázquez Fernández, on behalf of the PMIT-2 Working Group *
Corresponding author
mdiez@isciii.es
Correspondence: Dr. M. Díez. Unidad de Investigación en Tuberculosis. Instituto de Salud Carlos III. Sinesio Delgado, 6. 28029 Madrid. España
Correspondence: Dr. M. Díez. Unidad de Investigación en Tuberculosis. Instituto de Salud Carlos III. Sinesio Delgado, 6. 28029 Madrid. España
Unidad de Investigación en Tuberculosis, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
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Vázquez Fernández" "autores" => array:11 [ 0 => array:5 [ "preGrado" => "Dr." "nombre" => "M." "apellidos" => "Díez Ruiz-Navarro" "email" => array:1 [ 0 => "mdiez@isciii.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "J.A." "apellidos" => "Hernández Espinosa" ] 2 => array:2 [ "nombre" => "M.J." "apellidos" => "Bleda Hernández" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Díaz Franco" ] 4 => array:2 [ "nombre" => "C." "apellidos" => "Castells Carrillo" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Domínguez García" ] 6 => array:2 [ "nombre" => "A.M." "apellidos" => "García Fulgueiras" ] 7 => array:2 [ "nombre" => "P." "apellidos" => "Gayoso Diz" ] 8 => array:2 [ "nombre" => "M.J." "apellidos" => "López de Valdivielso" ] 9 => array:2 [ "nombre" => "M.F." "apellidos" => "Vázquez Fernández" ] 10 => array:2 [ "colaborador" => "on behalf of the PMIT-2 Working Group" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "fn1" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Unidad de Investigación en Tuberculosis, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr. M. Díez. Unidad de Investigación en Tuberculosis. Instituto de Salud Carlos III. Sinesio Delgado, 6. 28029 Madrid. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-07-08" "fechaAceptado" => "2005-01-18" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154102" "palabras" => array:3 [ 0 => "Outcome of tuberculosis treatment" 1 => "Potentially unsatisfactory outcome" 2 => "HIV status" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154103" "palabras" => array:3 [ 0 => "Resultados del tratamiento antituberculoso" 1 => "Resultado potencialmente insatisfactorio" 2 => "Estado VIH" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">TO analyze the effect of human immunodeficiency virus (HIV) status and other variables on the outcome of tuberculosis treatment in Spain.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">Multicenter retrospective cohort study in 6 autonomous communities of Spain (from May 1996 to April 1997). Data on treatment outcome were collected for new cases of tuberculosis in accordance with European guidelines. Follow up of patients continued for 3 months after scheduled end of treatment.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Of the 4899 patients included, 3417 (69.7%) had a satisfactory outcome, 438 (8.9%) died before or during treatment, and 1044 (21.4%) had a potentially unsatisfactory outcome. On stratification by HIV status, satisfactory outcome, mortality, and potentially unsatisfactory outcome were reported for 43.4%, 21.5%, and 35.1%, respectively, of HIV-positive patients; 71%, 6.2%, and 22.8%, respectively, of HIV-negative patients; and 74.3%, 7.5%, and 18.2%, respectively, of patients with no HIV status available. HIV modified the effect of several variables on the outcome of treatment, and so separate logistic regression models for each HIV category were constructed. Among HIV-positive patients, mortality increased in patients with neoplastic disease and in users of drugs by nonintravenous routes of administration, whereas potentially unsatisfactory outcomes increased in intravenous drug users and in women.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">In Spain, the outcome of tuberculosis treatment is much worse in HIV-positive patients. Drug use and presence of neoplastic disease substantially affect mortality.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Analizar el efecto del virus de la inmunodeficiencia humana (VIH) y otras variables sobre el resultado del tratamiento antituberculoso en España.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Estudio multicéntrico de cohorte retrospectivo en 6 comunidades autónomas (de mayo de 1996 a abril de 1997). Se recogió información sobre el resultado del tratamiento en casos nuevos de tuberculosis siguiendo la normativa europea. Se realizó seguimiento de los casos hasta 3 meses después de la fecha prevista de finalización del tratamiento.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">De los 4.899 pacientes incluidos, se observó un resultado satisfactorio en 3.417 (69,7%), 438 (8,9%) murieron antes o durante el tratamiento y 1.044 (21,4%) tuvieron un resultado potencialmente insatisfactorio. Estratificando por el estado de la infección por el VIH, las cifras fueron, respectivamente: para los que la presentaban, del 43,4, el 21,5 y el 35,1%; para los seronegativos, del 71, el 6,2 y el 22,8%, y para aquellos en quienes no constaba, del 74,3, el 7,5 y el 18,2%. El VIH modificaba el efecto de diversas variables sobre el resultado del tratamiento, por lo que se ajustaron modelos de regresión logística separados para cada categoría VIH. Entre los seropositivos, la mortalidad aumentó en enfermos con neoplasias y en usuarios de drogas por vías distintas de la parenteral, mientras que los resultados potencialmente insatisfactorios aumentaron en usuarios de drogas por vía intravenosa y en las mujeres.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">En España, el resultado del tratamiento antituberculoso es mucho peor en enfermos infectados por el VIH. El uso de drogas y el hecho de padecer neoplasias tienen un papel importante sobre la mortalidad.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara">The members of the PMIT-2 working group are listed at the end of the article. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 3 | 5 |
| 2024 October | 33 | 25 | 58 |
| 2024 September | 34 | 10 | 44 |
| 2024 August | 41 | 38 | 79 |
| 2024 July | 22 | 17 | 39 |
| 2024 June | 24 | 52 | 76 |
| 2024 May | 34 | 25 | 59 |
| 2024 April | 17 | 27 | 44 |
| 2024 March | 18 | 17 | 35 |
| 2024 February | 17 | 21 | 38 |
| 2023 March | 1 | 6 | 7 |
| 2023 February | 14 | 21 | 35 |
| 2023 January | 19 | 28 | 47 |
| 2022 December | 16 | 21 | 37 |
| 2022 November | 15 | 22 | 37 |
| 2022 October | 20 | 27 | 47 |
| 2022 September | 14 | 25 | 39 |
| 2022 August | 15 | 32 | 47 |
| 2022 July | 17 | 39 | 56 |
| 2022 June | 14 | 31 | 45 |
| 2022 May | 17 | 36 | 53 |
| 2022 April | 13 | 31 | 44 |
| 2022 March | 16 | 33 | 49 |
| 2022 February | 22 | 43 | 65 |
| 2022 January | 12 | 35 | 47 |
| 2021 December | 16 | 46 | 62 |
| 2021 November | 16 | 42 | 58 |
| 2021 October | 19 | 40 | 59 |
| 2021 September | 16 | 47 | 63 |
| 2021 August | 6 | 25 | 31 |
| 2021 July | 15 | 27 | 42 |
| 2021 June | 17 | 35 | 52 |
| 2021 May | 8 | 31 | 39 |
| 2021 April | 22 | 42 | 64 |
| 2021 March | 27 | 26 | 53 |
| 2021 February | 8 | 21 | 29 |
| 2021 January | 6 | 9 | 15 |
| 2020 December | 13 | 13 | 26 |
| 2020 November | 11 | 18 | 29 |
| 2020 October | 9 | 7 | 16 |
| 2020 September | 6 | 8 | 14 |
| 2020 August | 10 | 12 | 22 |
| 2020 July | 11 | 17 | 28 |
| 2020 June | 3 | 6 | 9 |
| 2020 May | 19 | 17 | 36 |
| 2020 April | 11 | 12 | 23 |
| 2020 March | 9 | 17 | 26 |
| 2020 February | 13 | 18 | 31 |
| 2020 January | 17 | 10 | 27 |
| 2019 December | 14 | 16 | 30 |
| 2019 November | 16 | 19 | 35 |
| 2019 October | 8 | 6 | 14 |
| 2019 September | 3 | 4 | 7 |
| 2019 August | 14 | 12 | 26 |
| 2019 July | 9 | 14 | 23 |
| 2019 June | 5 | 4 | 9 |
| 2019 May | 6 | 10 | 16 |
| 2019 April | 11 | 9 | 20 |
| 2019 March | 11 | 16 | 27 |
| 2019 February | 11 | 16 | 27 |
| 2019 January | 6 | 4 | 10 |
| 2018 December | 11 | 17 | 28 |
| 2018 November | 18 | 12 | 30 |
| 2018 October | 13 | 11 | 24 |
| 2018 September | 9 | 9 | 18 |
| 2018 May | 1 | 2 | 3 |
| 2018 April | 10 | 9 | 19 |
| 2018 March | 1 | 4 | 5 |
| 2018 February | 7 | 10 | 17 |
| 2018 January | 9 | 10 | 19 |
| 2017 December | 5 | 5 | 10 |
| 2017 November | 5 | 4 | 9 |
| 2017 October | 8 | 9 | 17 |
| 2017 September | 5 | 11 | 16 |
| 2017 August | 7 | 10 | 17 |
| 2017 July | 5 | 4 | 9 |
| 2017 June | 7 | 13 | 20 |
| 2017 May | 7 | 14 | 21 |
| 2017 April | 2 | 4 | 6 |
| 2017 March | 2 | 24 | 26 |
| 2017 February | 3 | 5 | 8 |
| 2017 January | 3 | 3 | 6 |
| 2016 December | 8 | 8 | 16 |
| 2016 November | 12 | 7 | 19 |
| 2016 October | 11 | 14 | 25 |
| 2016 September | 7 | 10 | 17 |
| 2016 August | 6 | 4 | 10 |
| 2016 July | 3 | 5 | 8 |
| 2016 March | 1 | 0 | 1 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 52 | 1 | 53 |
| 2015 September | 49 | 4 | 53 |
| 2015 August | 38 | 7 | 45 |
| 2015 July | 31 | 6 | 37 |
| 2015 June | 30 | 2 | 32 |
| 2015 May | 39 | 8 | 47 |
| 2015 April | 27 | 9 | 36 |
| 2015 March | 24 | 6 | 30 |
| 2015 February | 23 | 3 | 26 |
| 2015 January | 30 | 5 | 35 |
| 2014 December | 22 | 2 | 24 |
| 2014 November | 18 | 5 | 23 |
| 2014 October | 27 | 9 | 36 |
| 2014 September | 24 | 8 | 32 |
| 2014 August | 23 | 8 | 31 |
| 2014 July | 26 | 6 | 32 |
| 2014 June | 34 | 16 | 50 |
| 2014 May | 37 | 10 | 47 |
| 2014 April | 32 | 8 | 40 |
| 2014 March | 46 | 9 | 55 |
| 2014 February | 41 | 6 | 47 |
| 2014 January | 26 | 8 | 34 |
| 2013 December | 28 | 6 | 34 |
| 2013 November | 24 | 9 | 33 |
| 2013 October | 20 | 5 | 25 |
| 2013 September | 29 | 9 | 38 |
| 2013 August | 22 | 13 | 35 |
| 2013 July | 38 | 8 | 46 |
| 2013 June | 22 | 4 | 26 |
| 2013 May | 28 | 4 | 32 |
| 2013 April | 19 | 5 | 24 |
| 2013 March | 6 | 1 | 7 |
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