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Survival of healthy HIV-infected skin-test anergic and non-anergic adults from a voluntary counseling and testing clinic in Kampala, Uganda.




 

Int Conf AIDS. 1998;12:151 (abstract no. 13324). Unique Identifier :

OBJECTIVE: To compare the two-year survival of healthy Ugandans with skin test anergy and non-anergy to tuberculin and candida at baseline. DESIGN: Prospective cohort study. METHODS: Between 1993 and 1995, 321 (mean age 30.6 +/- 6.5 yrs., 31% male) anergic and 461 (30.4 +/- 6.6 yrs., 33% male) non-anergic to tuberculin and candida skin tests were recruited from an anonymous voluntary counseling testing centre in Kampala, Uganda. These subjects were enrolled in the non-intervention arm of a three-year clinical trial to assess the efficacy of TB chemoprophylaxis. They received regular medical care for concomitant illnesses throughout the study period. RESULTS: At baseline 15.9% of the non-anergic compared with 23.9% of the anergic had a prior history of herpes zoster (p < .001); and 35.5% of the non-anergic compared with 45.5% of the anergic had present or past genital ulcers (p < .001). The mean CD4 cell count in the non-allergic was 529 +/- 380 cells/mu. and 359 +/- 313 cells/microliter in the anergic (p < .001). Both groups had similar haemoglobin, total white cell counts, weights and body mass indices. After two years of follow-up, there had been 68 deaths in the non-anergic compared with 96 in the anergic for a product limit estimate log rank chi 2 of 23.0 (p < .001). In a proportional hazards model controlling for baseline CD4 cell count, the relative hazard for anergic was 1.14 p < .093, -2 Log-likelihood 8565, p < .001, from a univariate relative hazard of 1.24 (p < .004), -2 Log-likelihood of 8717. CONCLUSIONS: In HIV-infected persons, TB was independently associated with an increased risk for death, especially when the CD4+ count was greater than 200 cells/microL. In populations with high prevalence of co-infection, preventive therapy for TB in HIV-infected persons may have beneficial effect on individual survival.

MEETING ABSTRACTS Adult Clonal Anergy Cohort Studies Community Health Centers CD4 Lymphocyte Count Female Human HIV Infections/COMPLICATIONS/*IMMUNOLOGY/*MORTALITY Male Proportional Hazards Models Prospective Studies Skin Tests/STATISTICS & NUMER DATA Survival Rate Tuberculosis/COMPLICATIONS Uganda



 




Information in this article was accurate in December 30, 1998. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.