{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:34:01Z","timestamp":1787758441414,"version":"build-2784847793"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,7]]},"abstract":"\n Background:<\/jats:title>\n \n Mortality from tuberculosis (TB) sepsis is common among patients living with human immunodeficiency virus (PLHIV). We aimed to detect\n M. tuberculosis<\/jats:italic>\n (MTB) and additional sepsis etiologies, and mortality determinants in PLHIV.\n <\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This prospective cohort study consented and followed-up PLHIV for 28 days in northern Tanzania. From May through December 2021, patients provided urine and sputum for TB testing in lateral-flow lipoarabinomannan (LF-LAM) and Xpert\u00ae MTB\/RIF. Bacterial blood culture, cryptococcal antigen, malaria rapid diagnostic, C-reactive-protein (CRP), and international normalized ratio (INR) tests were also performed. Sepsis severity was clinically measured by Karnofsky and modified early warning signs (MEWS) scores. Anti-TB, broad-spectrum antibiotics, and antimalarial and antifungal agents were prescribed in accordance with Tanzania treatment guideline. An independent\n t<\/jats:italic>\n -test and Chi-square or Fisher's exact tests compared means and proportions, respectively.\n P<\/jats:italic>\n < 0.05 was statistically significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Among 98 patients, 59 (60.2%) were female. Their mean (standard deviation) age was 44 (12.9) years. TB detection increased from 24 (24.5%) by Xpert\u00ae MTB\/RIF to 36 (36.7%) when LF-LAM was added. In total, 23 (23.5%) patients had other than TB etiologies of sepsis, including\n Staphylococcus aureus, Streptococcus pneumoniae, Cryptococcus<\/jats:italic>\n spp., and\n Plasmodium<\/jats:italic>\n spp. Twenty-four (94.4%) of 36 patients with TB had higher CRP (\u226510 mg\/l) compared to 25 (40.3%) non-TB patients (\n P<\/jats:italic>\n < 0.001). Nine (9.2%) patients died and almost all had INR \u22651.8 (\n n<\/jats:italic>\n = 8), Karnofsky score <50% (\n n<\/jats:italic>\n = 9), MEWS score >6 (\n n<\/jats:italic>\n = 8), and malnutrition (\n n<\/jats:italic>\n = 9).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n \n MTB<\/jats:italic>\n and other microbes contributed to sepsis in PLHIV. Adding non-TB tests informed clinical decisions. Mortality was predicted by conventional sepsis and severity scoring, malnutrition, and elevated INR.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijmy.ijmy_80_22","type":"journal-article","created":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T02:59:47Z","timestamp":1662951587000},"page":"241-248","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Multiple Pathogens Contribute to Human Immunodeficiency Virus-Related Sepsis in Addition to Mycobacterium tuberculosis"],"prefix":"10.4103","volume":"11","author":[{"given":"Donatus Bonphace","family":"Tsere","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Mkilema","family":"Shirima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian 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