Www.ias2011.org Causes of death and risk factors of mortality in HIV-infected patients treated for tuberculosis enrolled in the CAMELIA trial (ANRS 1295/12160.

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Presentation transcript:

Causes of death and risk factors of mortality in HIV-infected patients treated for tuberculosis enrolled in the CAMELIA trial (ANRS 1295/12160 – CIPRA KH001/10425) O. Marcy, D. Laureillard, S. Chan, Y. Madec, C. Mayaud, L. Borand, N. Prak, C. Kim, K.K. Lak, C. Hak, B. Dim, T. Sok, A.E. Goldfeld and F.X. Blanc 21 July, 2011 Oral poster discussion session, 6th IAS Conference, Roma

Study design HIV+ patients with AFB+ tuberculosis (TB) and CD4 ≤ 200/mm 3 TB regimen: 2RHEZ/4RH Randomized to start ART (D4T/3TC/EFV) Early: 2 weeks after TB treatment onset Late: 8 weeks after TB treatment onset Primary endpoint: survival Causes of death were secondarily assessed ANRS 1295/12160 – CIPRA KH001/10425 study

Mortality Median follow-up duration: 25 months 149 / 661 (22%) enrolled patients died Place of death: –63 (42%) deaths occurred at home –86 (58%) occurred in hospital ANRS 1295/12160 – CIPRA KH001/10425 study Period of timeDeaths n (%) Mortality rate / 100 PYs (95% CI) Inclusion to Wk 2687 (58) 28.9 (23.4 – 35.6) >Wk 26 to Wk 5022 (15) 8.5 (5.6 – 12.9) >Wk 5040 (27)4.9 (3.6 – 6.7)

Causes of death Early n (%) Late n (%) Total n (%) Tuberculosis Drug-induced toxicity Gastrointestinal disorders Infection dis. and PML Respiratory distress Cachexia Neurologic disorders Hepatic disorders IRIS Neoplasia Suicide Road accident Unknown 13 (22) 5 (9) 6 (10) 5 (9) 3 (5) 6 (10) - 2 (3) - 4 (7) 29 (32) 12 (13) 10 (11) 7 (8) 4 (5) 3 (3) 5 (6) - 3 (3) 1 (1) 2 (2) 9 (10) 42 (28) 17 (12) 16 (11) 13 (9) 10 (7) 8 (5) 6 (4) 3 (2) 2 (1) 13 (9) Total59 (100)90 (100)149 (100) ANRS 1295/12160 – CIPRA KH001/10425 study

Adjusted HR (95% CIp ArmEarly Late (1.16 – 2.27) Age, years≤ ≥ (0.81 – 1.98) 1.87 (1.18 – 2.95) 0.03 BMI, kg/m 2 < > (1.03 – 2.54) 0.84 (0.47 – 1.48) 1.08 (0.62 – 1.91) Karnofsky score≥ ≤ (0.83 – 3.09) 4.69 (2.17 – 10.11) <0.001 AST, ULN≤1.25 > (1.08 – 2.18) 0.02 TB locationPulmonary Extra-pulmonary Disseminated Non-TB mycobact (0.52 – 2.01) 2.55 (1.78 – 3.65) 3.21 (1.35 – 7.63) <0.001 TB drug resistanceNo Yes Yes, MDR (0.68 – 1.74) 7.65 (3.45 – 16.99) <0.001 Risk factors of mortality