TB as a cause of hospitalization and in‐hospital mortality among people living with HIV worldwide: a systematic review and meta‐analysis

Journal of the International AIDS Society - Tập 19 Số 1 - 2016
Nathan Ford1, Alberto Matteelli2,3, Zara Shubber4, Sabine Hermans5,6, Graeme Meintjes7, Beatriz Grinsztejn8, Greer Waldrop9, Katharina Kranzer10,11, Meg Doherty1, Haileyesus Getahun3
1Department of HIV, World Health Organization, Geneva, Switzerland
2Clinic of Infectious and Tropical Diseases, WHO Collaborating Centre for TB/HIV and TB Elimination, University of Brescia, Brescia, Italy
3Global TB Programme, World Health Organization, Geneva, Switzerland
4Department of Infectious Disease Epidemiology, Imperial College London, London, UK
5Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
6Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa
7Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
8Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Ministry of Health, Rio de Janeiro, Brazil
9University of Maryland School of Medicine, Baltimore, MD USA
10Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
11National and Supranational Tuberculosis Reference Laboratory, Research Centre Borstel, Germany

Tóm tắt

IntroductionDespite significant progress in improving access to antiretroviral therapy over the past decade, substantial numbers of people living with HIV (PLHIV) in all regions continue to experience severe illness and require hospitalization. We undertook a global review assessing the proportion of hospitalizations and in‐hospital deaths because of tuberculosis (TB) in PLHIV.MethodsSeven databases were searched to identify studies reporting causes of hospitalizations among PLHIV from 1 January 2007 to 31 January 2015 irrespective of age, geographical region or language. The proportion of hospitalizations and in‐hospital mortality attributable to TB was estimated using random effects meta‐analysis.ResultsFrom an initial screen of 9049 records, 66 studies were identified, providing data on 35,845 adults and 2792 children across 42 countries. Overall, 17.7% (95% CI 16.0 to 20.2%) of all adult hospitalizations were because of TB, making it the leading cause of hospitalization overall; the proportion of adult hospitalizations because of TB exceeded 10% in all regions except the European region. Of all paediatric hospitalizations, 10.8% (95% CI 7.6 to 13.9%) were because of TB. There was insufficient data among children for analysis by region. In‐hospital mortality attributable to TB was 24.9% (95% CI 19.0 to 30.8%) among adults and 30.1% (95% CI 11.2 to 48.9%) among children.DiscussionTB remains a leading cause of hospitalization and in‐hospital death among adults and children living with HIV worldwide.

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Journal of the International AIDS Society

Tập 19 Số 1

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