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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: METHODS, OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, Antitubercular Agents, Brazil, Cause of Death, Chi-Square Distribution, Coinfection, Databases, Factual, Disease Progression, Female, HIV Infections, Humans, Immunocompromised Host, Male, Middle Aged, Odds Ratio, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Tuberculosis, Urban Health.
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Is tuberculosis associated with non-tuberculosis-related deaths among HIV/AIDS patients in Rio de Janeiro? Context: Human immunodeficiency virus (HIV) infected patients followed in a large cohort in Rio de Janeiro, Brazil. To evaluate the association of tuberculosis (TB) and other covariables with non-TB-related (NTR) causes of death (CODs). Patients aged >18 years were followed from 1997 to 2009, until death or 31 December 2009, whichever was earlier. CODs were ascertained using a standardised algorithm. TB diagnosis and prophylaxis followed Brazilian guidelines. Poisson models were used to calculate adjusted rate ratios (aRRs). Of 2887 patients included in the study, 761 had TB (26.4%). NTR death rates were twice as high among patients with TB (4/100 vs. 2.09/100 patient-years). TB was associated with NTR deaths (aRR 1.4, 95%CI 1.05-1.86, P = 0.01). Highly active antiretroviral treatment (HAART) was protective against NTR (aRR 0.46, 95%CI 0.34-0.61, P < 0.001). Among patients who had never had active TB, prophylaxis was also protective against NTR (aRR 0.45, P = 0.04). The CD4 cell count increase was very modest for both TB and NTR CODs compared to those who did not die (0 vs. 249 cells, P < 0.001).
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TB was significantly associated with increased NTR CODs, indicating rapid progression of disease and increased long-term risk of mortality, probably related to persistent immunodeficiency or incomplete immune recovery. Our results confirm the benefits of HAART and TB prophylaxis. Final Decision: yes