association of bmi category change with tb treatment mortality in hiv-positive smear-negative and extrapulmonary tb patients in myanmar and zimbabwe协会的bmi类别变化与艾滋病毒阳性的结核治疗死亡率涂阴肺外结核病患者在缅甸和津巴布韦.pdf

Association of BMI Category Change with TB Treatment Mortality in HIV-Positive Smear-Negative and Extrapulmonary TB Patients in Myanmar and Zimbabwe 1 1 2 2 3 Lenka Benova *, Katherine Fielding , Jane Greig , Bern-Thomas Nyang’wa , Esther Carrillo Casas , Marcio Silveira da Fonseca3, Philipp du Cros2 ´ ` ´ ` 1 London School of Hygiene and Tropical Medicine, London, United Kingdom, 2 Medecins Sans Frontieres, London, United Kingdom, 3 Medecins Sans Frontieres, Amsterdam, Holland Abstract Objective: The HIV epidemic has increased the proportion of patients with smear-negative and extrapulmonary tuberculosis (TB) diagnoses, with related higher rates of poor TB treatment outcomes. Unlike in smear-positive pulmonary TB, no interim markers of TB treatment progress are systematically used to identify individuals most at risk of mortality. The objective of this study was to assess the association of body mass index (BMI) change at 1 month ( 615 days) from TB treatment start with mortality among HIV-positive individuals with smear-negative and extrapulmonary TB. ´ ` Methods and Findings: A retrospective cohort study of adult HIV-positive new TB patients in Medecins Sans Frontieres (MSF) treatment programmes in Myanmar and Zimbabwe was conducted using Cox proportional hazards regression to estimate the association between BMI category change and mortality. A cohort of 1090 TB patients (605 smear-negative and 485 extrap