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Table 2 Cox-regression model for survival in Eastern Europe, crude and adjusted hazard ratios (24 months follow-up)

From: Delayed diagnosis of tuberculosis in persons living with HIV in Eastern Europe: associated factors and effect on mortality—a multicentre prospective cohort study

  Total (n = 740) Crude HR (95% CI) p-value Adjusted HR (95% CI)a p-value
Delayed diagnosis ≥ 1 month (n = 480) 1.36 (1.04–1.77) 0.023 1.27 (0.95–1.70) 0.103
Gender Male (n = 563) 1.34 (1.02–1.76) 0.032 1.38 (1.04–1.83) 0.026
Age Age 18–49 (n = 694) Ref Ref   
  Age ≥ 50 (n = 46) 0.92 (0.55–1.52) 0.741   
Exposure group (HIV) MSM (n = 10) 0.49 (0.12–1.95) 0.309   
  IDU (n = 422) 1.19 (0.93–1.52) 0.173   
  Heterosexual (n = 183) 0.84 (0.63–1.13) 0.255   
Known HIV positive At baseline (n = 668) 1.55 (0.96–2.50) 0.074 1.43 (0.84–2.42) 0.185
Treatment history (HIV) Naïve at TB diagnosisc (n = 558) 1.04 (0.79–1.38) 0.766   
ART at baselinec (n = 132) 0.96 (0.70–1.31) 0.795   
  Cotrimoxazole at baseline (n = 273) 1.22 (0.96–1.56) 0.110   
CD4-cell count/mm3° 0–199/mm3 (n = 440) 2.17 (1.53–3.09) 0.001 1.84 (1.27–2.68) 0.001
≥ 200/mm3 (n = 185) Ref Ref Ref Ref
Missing CD4 (n = 115) 2.17 (1.41–3.33) 0.001 2.32 (1.47–3.66) 0.001
Prior AIDS Yes (n = 177) 1.87 (1.45–2.41) 0.001 1.69 (1.27–2.24) 0.001
Previous TB Yes (n = 99) 0.97 (0.68–1.39) 0.880   
TB risk factor Alcohol abuse (n = 186) 1.32 (1.01–1.73) 0.041 1.24 (0.92–1.68) 0.158
  Recent TB in family (n = 53) 0.84 (0.50–1.42) 0.524   
  Prison within the last 2 years (n = 143) 1.11 (0.82–1.51) 0.493   
Clinical presentation of TB Pulmonary (n = 239) Ref Ref Ref Ref
  Extrapulmonary (n = 54) 0.98 (0.51–1.88) 0.957 0.86 (0.44–1.68) 0.657
  Disseminated (n = 447) 2.31 (1.71–3.11) 0.001 1.93 (1.38–2.69) 0.001
TB symptoms at diagnosis Cough (n = 501) 0.95 (0.74–1.23) 0.708   
  Fever (n = 636) 1.59 (1.07–2.37) 0.022 1.41 (0.91–2.19) 0.124
  Weight loss (n = 445) 1.70 (1.31–2.21) 0.001 1.41 (1.05–1.88) 0.022
Number of symptoms§ None (n = 20) Ref Ref   
  One symptom (n = 133) 0.89 (0.38–2.11) 0.793   
  Two symptoms (n = 312) 1.12 (0.49–2.56) 0.783   
  Three symptoms (n = 275) 1.58 (0.69–3.58) 0.277   
Screening chest X-ray in pastd Yes (n = 338) 1.30 (1.02–1.66) 0.034 1.27 (0.93–1.74) 0.133
Rifampicin resistance Yes (n = 95) 1.53 (1.12–2.10) 0.007 Omittedb  
MDR-TB Yes (n = 88) 2.61 (1.68–4.05) 0.001 2.06 (1.06–4.01) 0.033
  No (n = 148) Ref Ref Ref  
  Missing (n = 504) 1.84 (1.28–2.64) 0.001 1.32 (0.68–2.57) 0.407
Diagnosis Definitive (n = 333) Ref Ref Ref Ref
  Probable (n = 76) 1.43 (0.97–2.11) 0.074 0.99 (0.61–1.59) 0.955
  Presumptive (n = 331) 1.03 (0.80–1.34) 0.795 0.95 (0.67–1.35) 0.764
Hepatis B HBsAg positive (n = 44)d 0.95 (0.56–1.60) 0.843   
Hepatitis C Anti-HCV positive (n = 405)d 1.20 (0.94–1.53) 0.145   
Drug-susceptibility testing At baseline (n = 236) 0.84 (0.65–1.08) 0.175   
Treatment with RHZ At baseline (n = 591) 0.81 (0.59–1.09) 0.157   
Treatment with at least three active drugs At baseline (n = 132) 0.64 (0.46–0.91) 0.014 0.81 (0.52–1.25) 0.344
  1. HR hazard ratio, CI confidence interval, MSM Men Who Have Sex with Men, IDU injecting drug use
  2. Global Test Proportional Hazard Assumption p = 0.3689, individually all > 0.05
  3. aAdjusted for diagnostic delay, gender, known HIV positive, CD4 cell count, prior aids, tb risk factor alcohol, clinical presentation (all), Tb symptoms (fever, weight loss), chest x-ray, MDR-TB, type of diagnosis, treatment with at least three active drugs, stratified by Center
  4. bOmitted Rifampicin resistance in the multivariable model due to multicollinearity with MDR-TB
  5. cThose not included in the categories “ART naïve at TB diagnosis” and”ART use at TB diagnosis” have previously received ART and interrupted their treatment
  6. dThose with missing information for chest x-ray (n = 278), HBsAg (n = 215), Anti-HCV (n = 220) assumed negative
  7. § Index based on symptoms cough, fever, weight loss
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BMC Infectious Diseases

ISSN: 1471-2334

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