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. 2015 May;105(5):930-7.
doi: 10.2105/AJPH.2014.302431. Epub 2015 Mar 19.

Mortality hazard and survival after tuberculosis treatment

Thaddeus L Miller  1 , Fernando A Wilson, Jenny W Pang, Suzanne Beavers, Sally Hoger, Sharon Sharnprapai, Melissa Pagaoa, Dolly J Katz, Stephen E Weis
Affiliations

Mortality hazard and survival after tuberculosis treatment

Thaddeus L Miller et al. Am J Public Health. 2015 May.

Abstract

Objectives: We compared mortality among tuberculosis (TB) survivors and a similar population.

Methods: We used local health authority records from 3 US sites to identify 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 11 135 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.

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Figures

FIGURE 1—
FIGURE 1—
Age, gender, race/ethnicity, HIV status, and nativity-adjusted Cox regression survival probability by tuberculosis history: Centers for Disease Control and Prevention’s National Death Index; Texas, Massachusetts, and Seattle and King County, WA; 2008. Note. TB = tuberculosis. Treatment completion indicates a history of active TB; entry into observation indicates no history of active TB.
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