AvaliaÃÃo de desfecho do tratamento para tuberculose em pacientes com HIV/AIDS

AUTOR(ES)
DATA DE PUBLICAÇÃO

2005

RESUMO

A cohort retrospective study was carried out in order to settle the frequency of unfavorable outcomes (death, desertion and failure) and of deaths separately in patients with HIV/aids treated for tuberculosis without laboratorial confirmation of diagnosis and to compare this frequency with that one of unfavorable outcomes in treated patients with laboratorial confirmation of diagnosis, in the period between July of 2002 and June of 2004, in Hospital Correia PicanÃo. Assessed variables were placed into three groups: biological and socialdemographic variables, variables associated to HIV/aids and variables associated to tuberculosis, among which variables associated to signs and symptoms of tuberculosis, variables associated to presentation form and diagnosis criteria, variables associated to tuberculosis radiological pattern and variables associated to tuberculosis treatment were studied. Using the data of medical records, 262 patients were evaluated, among whom 93 (35.5%) initiated treatment for tuberculosis with diagnostic confirmation and 169 (64.5%) without confirmation. From all patients, 7 (2.7%) achieved cure with laboratory confirmation, 147 (56.1%) were cured without laboratory confirmation, 30 (11.5%) abandoned treatment, 2 (0.8%) presented treatment failure by development of resistance and 76 (29%) died. Crude and adjusted odds ratios, confidence intervals and âpâ values of the association between unfavorable outcomes and independent variables were estimated in each group. Then, variables selected in the multivariate analysis in each group were controlled for effect of those selected in the other groups. The variables retained in the final model of the multivariate analysis, because presented statistically significant association with unfavorable outcome after all adjustments, were: co-existence of other opportunistic diseases, CD4 and viral load, dyspnea, disseminated form of tuberculosis and changing in scheme of treatment because of adverse reaction or intolerance. When assessed outcome was death, the variables retained in the final model of the multivariate analysis were: anti-retroviral treatment, CD4 and viral load, dyspnea and assistance regimen at beginning of tuberculosis treatment

ASSUNTO(S)

medicina hospital correia picanÃo hiv/aids hiv/aids tuberculose correia picanÃo hospital tuberculosis

ACESSO AO ARTIGO

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