CD4+lymphocytes and tuberculin skin test as survival predictors in pulmonary tuberculosis HIV-infected patients.
Background We analyse whether the tuberculin skin test is a good survival marker in a cohort of pulmonary tuberculosis patients with HIV infection (PTB/HIV).
In all, 494 PTB/HIV patients were enrolled in Barcelona (Spain) between January 1992 and December 1994 in the Tuberculosis Program of Barcelona.
The main data problem was the large proportion of missing values in the covariates percentage of T CD4+lymphocytes and the tuberculin test results : only 157 patients (31.8%) had both covariates recorded.
Methods Patients were dichotomized into two groups according to their level of immunosuppression (¾14 and>14% T CD4+cells).
First, we carried out the semiparametric and parametric complete case analysis.
After this, we analysed the data assuming a missing at random non-response pattern.
We developed a bootstrap approach where missing data in the markers are imputed via a two-way linear model.
Using Weibull regression estimation, we used a multiple imputation scheme to estimate the parameters of interest.
Results We found significative differences for the most immunosuppressed group when comparing positive tuberculin patients with those who were tuberculin negative.
From a complete case approach and through a multivariate Cox analysis, we obtained a significant relative hazard of 0.3657 (95% CI : 0.13-1.02 ; P=0.054).
When a Weibull model was fitted, we estimated a constant relative percentile value of pR=4.1329 (95% CI : 0.97-17.59). (...)
Mots-clés Pascal : Tuberculose, Mycobactériose, Bactériose, Infection, Poumon, SIDA, Virose, Virus immunodéficience humaine, Lentivirus, Retroviridae, Virus, Tuberculine, Test cutané, Lymphocyte, Indicateur, Epidémiologie, Pronostic, Survie, Prédicteur, Homme, Méthodologie, Espagne, Europe, Appareil respiratoire pathologie, Poumon pathologie, Immunopathologie, Immunodéficit
Mots-clés Pascal anglais : Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Lung, AIDS, Viral disease, Human immunodeficiency virus, Lentivirus, Retroviridae, Virus, Tuberculin, Skin test, Lymphocyte, Indicator, Epidemiology, Prognosis, Survival, Predictor, Human, Methodology, Spain, Europe, Respiratory disease, Lung disease, Immunopathology, Immune deficiency
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0440595
Code Inist : 002B05C02D. Création : 25/01/1999.