       Document 0193
 DOCN  M9630193
 TI    Does the onset of tuberculosis in AIDS predict shorter survival? Results
       of a cohort study in 17 European countries over 13 years. AIDS in Europe
       Study Group.
 DT    9603
 AU    Perneger TV; Sudre P; Lundgren JD; Hirschel B; Institute of Social and
       Preventive Medicine, University of; Geneva, Switzerland.
 SO    BMJ. 1995 Dec 2;311(7018):1468-71. Unique Identifier : AIDSLINE
       MED/96096391
 AB    OBJECTIVE--To assess the impact of tuberculosis on mortality in patients
       with AIDS. DESIGN--Community based cohort study. SETTING--52 centres in
       17 countries (AIDS in Europe study). SUBJECTS--5249 patients who were
       alive and free of tuberculosis one month after the diagnosis of AIDS,
       enrolled between 1979 and 1989, and followed up until 1992. MAIN OUTCOME
       MEASURES--Onset of clinically active tuberculosis or death, or both.
       RESULTS--During a mean follow up period of 15 months 201 (4%) patients
       developed tuberculosis and 3889 (74%) died. Patients who developed
       tuberculosis survived significantly longer (median 22 months) than those
       who did not (median 16 months). This apparent survival advantage was due
       to patients who survived longer having more opportunity to develop
       tuberculosis (or any other disease). In models that took into account
       the time at which tuberculosis was diagnosed, the onset of tuberculosis
       was associated with a significant increase in mortality (adjusted
       relative hazard of death 1.34; 95% confidence interval 1.12 to 1.60).
       CONCLUSIONS--The onset of tuberculosis in patients with AIDS predicts a
       substantial increase in mortality. Whether this increased mortality is
       directly attributable to the tuberculosis remains uncertain. If the
       association is causal preventive chemotherapy and aggressive treatment
       of tuberculosis could improve survival in AIDS.
 DE    Acquired Immunodeficiency Syndrome/*MORTALITY  Adult  Aged  AIDS-Related
       Opportunistic Infections/*MORTALITY  Cohort Studies  Europe/EPIDEMIOLOGY
       Female  Follow-Up Studies  Human  Male  Middle Age  Prospective Studies
       Support, Non-U.S. Gov't  Survival Analysis  Survival Rate
       Tuberculosis/*MORTALITY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

