TY - JOUR
T1 - Mortality hazard and survival after tuberculosis treatment
AU - Miller, Thaddeus L.
AU - Wilson, Fernando A.
AU - Pang, Jenny W.
AU - Beavers, Suzanne
AU - Hoger, Sally
AU - Sharnprapai, Sharon
AU - Pagaoa, Melissa
AU - Katz, Dolly J.
AU - Weis, Stephen E.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Objectives: We compared mortality among tuberculosis (TB) survivors and a similar population. Methods: We used local health authority records from 3 USsites toidentify 3853 persons who completed adequate treatment of TB and 7282 individuals diagnosed with latent TB infection 1993 to 2002. We then retrospectively observed mortality after 6 to 16 years of observation. We ascertained vital status as of December 31, 2008, using the Centers for Disease Control and Prevention's National Death Index. We analyzed mortality rates, hazards, and associations using Cox regression. Results: We traced 11135 individuals over 119 772 person-years of observation. We found more all-cause deaths (20.7% vs 3.1%) among posttreatment TB patients than among the comparison group, an adjusted average excess of 7.6 deaths per 1000 person-years (8.8 vs 1.2; P<.001). Mortality among posttreatment TB patients varied with observable factors such as race, site of disease, HIV status, and birth country. Conclusions: Fully treated TB is still associated with substantial mortality risk. Cure as currently understood may be insufficient protection against TB-associated mortality in the years after treatment, and TB prevention may be a valuable opportunity to modify this risk.
AB - Objectives: We compared mortality among tuberculosis (TB) survivors and a similar population. Methods: We used local health authority records from 3 USsites toidentify 3853 persons who completed adequate treatment of TB and 7282 individuals diagnosed with latent TB infection 1993 to 2002. We then retrospectively observed mortality after 6 to 16 years of observation. We ascertained vital status as of December 31, 2008, using the Centers for Disease Control and Prevention's National Death Index. We analyzed mortality rates, hazards, and associations using Cox regression. Results: We traced 11135 individuals over 119 772 person-years of observation. We found more all-cause deaths (20.7% vs 3.1%) among posttreatment TB patients than among the comparison group, an adjusted average excess of 7.6 deaths per 1000 person-years (8.8 vs 1.2; P<.001). Mortality among posttreatment TB patients varied with observable factors such as race, site of disease, HIV status, and birth country. Conclusions: Fully treated TB is still associated with substantial mortality risk. Cure as currently understood may be insufficient protection against TB-associated mortality in the years after treatment, and TB prevention may be a valuable opportunity to modify this risk.
UR - http://www.scopus.com/inward/record.url?scp=84926642385&partnerID=8YFLogxK
U2 - 10.2105/AJPH.2014.302431
DO - 10.2105/AJPH.2014.302431
M3 - Article
C2 - 25790407
AN - SCOPUS:84926642385
SN - 0090-0036
VL - 105
SP - 930
EP - 937
JO - American Journal of Public Health
JF - American Journal of Public Health
IS - 5
ER -