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ABSTRACT: Setting
Four ambulatory clinics in Durban, South Africa.Objective
To test the relationships of patient characteristics, time to mycobacterial culture positivity, and mortality with urinary lipoarabinomannan (LAM) grade category.Design
Newly diagnosed human immunodeficiency virus (HIV) infected adults were screened for tuberculosis (TB) using sputum culture, tested for urinary LAM, and followed for up to 12 months. We performed multivariable ordinal logistic regression of risk factors for low (1 or 2) or high (3, 4, or 5) LAM grade. We used adjusted Cox regression models to determine the hazard ratios of time to culture positivity and death.Results
Among 683 HIV-infected adults, median CD4 count was 215 cells/mm³ (interquartile range 86-361 cells/mm³), 17% had culture-confirmed TB, and 11% died during follow-up. Smoking, tachycardia (pulse > 100 beats/minute), CD4 count < 100 cells/mm³, and TB culture positivity were each associated with higher LAM grade. In multivariate models, a high urine LAM grade was associated with four-fold increased hazard of culture positivity (P = 0.001) and two-fold increased hazard of mortality (P = 0.02). Among patients treated for TB, these associations were no longer statistically significant.Conclusion
In this population, a higher urine LAM grade was associated with shorter time to culture positivity and mortality; however, these associations were not present for those starting anti-tuberculosis treatment.
SUBMITTER: Kubiak RW
PROVIDER: S-EPMC6205186 | biostudies-literature | 2018 Nov
REPOSITORIES: biostudies-literature
Kubiak R W RW Herbeck J T JT Coleman S M SM Ross D D Freedberg K K Bassett I V IV Drain P K PK
The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease 20181101 11
<h4>Setting</h4>Four ambulatory clinics in Durban, South Africa.<h4>Objective</h4>To test the relationships of patient characteristics, time to mycobacterial culture positivity, and mortality with urinary lipoarabinomannan (LAM) grade category.<h4>Design</h4>Newly diagnosed human immunodeficiency virus (HIV) infected adults were screened for tuberculosis (TB) using sputum culture, tested for urinary LAM, and followed for up to 12 months. We performed multivariable ordinal logistic regression of ...[more]