Long-term case-fatality rate of nontuberculous mycobacterial disease in people living with HIV.

IF 4.8 1区医学 Q1 INFECTIOUS DISEASES

Infectious Diseases of Poverty Pub Date : 2022-02-07 DOI:10.1186/s40249-022-00942-8

Jingjing Hu, Ling Gu, Yueming Shao, Renfang Zhang, Tangkai Qi, Jianjun Sun, Zhenyan Wang, Wei Song, Yang Tang, Jiangrong Wang, Shuibao Xu, Junyang Yang, Yinzhong Shen, Li Liu, Jun Chen, Hongzhou Lu

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引用次数: 3

Abstract

Background: Few data are available regarding the long-term case-fatality rate (CFR) among people living with HIV (PLWH) with nontuberculous mycobacteria (NTM) disease. The aim of this study is to analyze the long-term CFR in patients with NTM disease and to identify risk factors for their death.

Methods: A retrospective cohort study of 379 cases of microbiologically confirmed NTM disease in PLWH was conducted from January 1, 2012, to December 31, 2020, in Shanghai, China. We used Kaplan-Meier survival analysis and the log-rank test to compare the long-term CFR in patients with disseminated NTM (DNTM) and localized NTM disease. Univariate Cox proportional hazards regression analysis and a stepwise Cox proportional hazards regression model were used to estimate the predictors of long-term CFR.

Results: The cohort was followed up for a median of 26 months. The total CFR was 15.7% by one year and increased to 22.6% at 5 years after the diagnosis of NTM disease. The 5-year CFR of PLWH with DNTM was significantly higher than that of PLWH with localized NTM (26.7% vs 19.6% for DNTM and localized NTM disease, respectively). Older age [hazard ratio (HR) = 1.04, 95% confidence interval (CI): 1.02-1.06, P < 0.001], comorbidity (HR = 2.05, 95% CI: 1.21-3.49, P < 0.01), DNTM (HR = 2.08, 95% CI: 1.17-3.68, P < 0.05), and HIV viral load (HR = 1.32, 95% CI: 1.12-1.55, P < 0.001) were all independent risk factors for long-term CFR. In the subgroup analysis, time to culture positivity was negatively correlated with CFR in patients with DNTM (HR = 0.90, 95% CI: 0.82-0.98, P < 0.05).

Conclusions: NTM was associated with a high long-term CFR in PLWH. Further approaches to prevent NTM disease in PLWH are urgently needed.

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艾滋病毒感染者非结核分枝杆菌病的长期病死率。

背景:很少有关于非结核分枝杆菌(NTM)病的HIV感染者(PLWH)的长期病死率(CFR)的数据。本研究的目的是分析NTM患者的长期CFR，并确定其死亡的危险因素。方法:对2012年1月1日至2020年12月31日在中国上海PLWH中微生物学证实的379例NTM病进行回顾性队列研究。我们采用Kaplan-Meier生存分析和log-rank检验比较播散性NTM (DNTM)和局限性NTM患者的长期CFR。采用单因素Cox比例风险回归分析和逐步Cox比例风险回归模型估计长期CFR的预测因子。结果:该队列随访时间中位数为26个月。总CFR为15.7%，诊断为NTM疾病后5年升至22.6%。PLWH合并DNTM的5年CFR明显高于PLWH合并局限性NTM的5年CFR (DNTM和局限性NTM分别为26.7%和19.6%)。高龄[危险比(HR) = 1.04, 95%可信区间(CI): 1.02-1.06, P]结论:NTM与PLWH患者较高的长期CFR相关。迫切需要采取进一步措施，在公共卫生机构中预防NTM疾病。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infectious Diseases of Poverty Medicine-Public Health, Environmental and Occupational Health

CiteScore

16.70

自引率

1.20%

发文量

368

审稿时长

13 weeks

期刊介绍： Infectious Diseases of Poverty is a peer-reviewed, open access journal that focuses on essential public health questions related to infectious diseases of poverty. It covers a wide range of topics and methods, including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies, and their application. The journal also explores the impact of transdisciplinary or multisectoral approaches on health systems, ecohealth, environmental management, and innovative technologies. It aims to provide a platform for the exchange of research and ideas that can contribute to the improvement of public health in resource-limited settings. In summary, Infectious Diseases of Poverty aims to address the urgent challenges posed by infectious diseases in impoverished populations. By publishing high-quality research in various areas, the journal seeks to advance our understanding of these diseases and contribute to the development of effective strategies for prevention, diagnosis, and treatment.