Anemia and anti-tuberculosis treatment outcome in persons with pulmonary tuberculosis: A multi-center prospective cohort study.
Anemia and anti-tuberculosis treatment outcome in persons with pulmonary tuberculosis: A multi-center prospective cohort study.
复制标题
DOI：
10.1016/j.jiph.2023.04.009
复制
发表时间：
2023-06
影响因子：
6.7
通讯作者：
Lapa-e-Silva, Jose R.
中科院分区：
文献类型：
--
作者：
Araujo-Pereira, Mariana;Nogueira, Betania M. F.;Spener-Gomes, Renata;Carvalho, Anna C. C.;Sant'Anna, Flavia Marinho;Figueiredo, Marina C.;Turner, Megan M.;Kritski, Afranio L.;Cordeiro-Santos, Marcelo;Rolla, Valeria C.;Sterling, Timothy R.;Andrade, Bruno B.;Andrade, Alice M. S.;Nascimento, Vanessa;Cubillos-Angulo, Juan Manuel;Malta-Santos, Hayna;Reboucas-Silva, Jessica;Santos, Saulo R. N.;Ramos, Andre;Brito, Pedro;Schmaltz, Carolina A. S.;Costa, Alysson G.;Garcia, Leandro Sousa;Carvalho, Brenda K. de Sousa;Loiola, Bruna P. de;Gomes-Silva, Adriano;Ignacio, Francine P.;Lourenco, Maria C.;Silva, Elisangela C.;Mello, Mayla;Souza, Alexandra B.;Barreto-Duarte, Beatriz;Rocha, Michael S.;Benjamin, Aline;Moreira, Adriana S. R.;Oliveira, Jamile G. de;Cavalcante, Solange;Durovni, Betina;Lapa-e-Silva, Jose R.
结核病（TB）仍然是人类的一大瘟疫。结核病患者 (PWTB) 通常患有贫血。在这里，我们评估了抗结核治疗（ATT）前 PWTB 贫血的严重程度是否是不良结果的危险因素。对 2015 年至 2019 年间纳入巴西多中心队列的 18 岁以上经培养确诊药物敏感肺结核患者进行长达 24 个月的随访，并根据血红蛋白水平根据贫血严重程度（轻度、中度和重度）进行分类。采用多项逻辑回归模型来评估与治疗成功（治愈或治疗完成）相比，贫血是否与不良结果（死亡、失败、失访、方案修改或复发）相关。在符合纳入标准的 786 名参与者中，441 名（56%）在基线时患有贫血。与其他组相比，中度/重度贫血患者的艾滋病毒血清阳性率更高，症状更明显，并且出现不良结果的频率更高。中度/重度贫血（调整后 OR [aOR]：7.80，95%CI：1.34–45.4，p = 0.022）与死亡相关，与性别、年龄、BMI、HIV 和血糖状况无关。 ATT 之前的中度/重度贫血是死亡的重要危险因素。鉴于 ATT 不良结果的高风险，应对此类患者进行密切监测。
Tuberculosis (TB) remains a major plague of humanity. People with TB (PWTB) are commonly anemic. Here, we assessed whether the severity of anemia in PWTB prior to anti-TB treatment (ATT) was a risk factor for an unfavorable outcome. Patients ≥ 18 years old with culture-confirmed drug-susceptible pulmonary TB enrolled between 2015 and 2019 in a multi-center Brazilian cohort were followed for up to 24 months and classified according to anemia severity (mild, moderate, and severe), based on hemoglobin levels. A multinomial logistic regression model was employed to assess whether anemia was associated with unfavorable outcome (death, failure, loss to follow-up, regimen modification or relapse), compared to treatment success (cure or treatment completion). Among 786 participants who met inclusion criteria, 441 (56 %) were anemic at baseline. Patients with moderate/severe anemia were more HIV-seropositive, as well as more symptomatic and had higher frequencies of unfavorable outcomes compared to the other groups. Moderate/severe anemia (adjusted OR [aOR]: 7.80, 95 %CI:1.34–45.4, p = 0.022) was associated with death independent of sex, age, BMI, HIV and glycemic status. Moderate/severe anemia prior to ATT was a significant risk factor for death. Such patients should be closely monitored given the high risk of unfavorable ATT outcomes.
登录
查看更多内容
影响因子：
4.7
作者：
Gelaw Y;Getaneh Z;Melku M
通讯作者：
Melku M
影响因子：
7.3
作者：
通讯作者：
--
影响因子：
7.3
作者：
Carvalho ACC;Amorim G;Melo MGM;Silveira AKA;Vargas PHL;Moreira ASR;Rocha MS;Souza AB;Arriaga MB;Araújo-Pereira M;Figueiredo MC;Durovni B;Lapa-E-Silva JR;Cavalcante S;Rolla VC;Sterling TR;Cordeiro-Santos M;Andrade BB;Silva EC;Kritski AL;RePORT Brazil consortium
通讯作者：
RePORT Brazil consortium
影响因子：
6.4
作者：
Arriaga, Maria B.;Araujo-Pereira, Mariana;Andrade, Bruno B.
通讯作者：
Andrade, Bruno B.
影响因子：
11.8
作者：
Minchella, Peter A.;Donkor, Simon;McDermid, Joann M.
通讯作者：
McDermid, Joann M.