<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1657-9534</journal-id>
<journal-title><![CDATA[Colombia Médica]]></journal-title>
<abbrev-journal-title><![CDATA[Colomb. Med.]]></abbrev-journal-title>
<issn>1657-9534</issn>
<publisher>
<publisher-name><![CDATA[Universidad del Valle]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1657-95342021000404875</article-id>
<article-id pub-id-type="doi">10.25100/cm.v52i3.4875</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Delayed HIV treatment, barriers in access to care and mortality in tuberculosis/HIV co-infected patients in Cali, Colombia]]></article-title>
<article-title xml:lang="es"><![CDATA[Retraso en el tratamiento para VIH, barreras en el acceso a la atención en salud y mortalidad en personas coinfectadas con tuberculosis y VIH en Cali, Colombia]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González-Duran]]></surname>
<given-names><![CDATA[Jorge A]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Plaza]]></surname>
<given-names><![CDATA[Regina V]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Luna]]></surname>
<given-names><![CDATA[Lucy]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arbeláez]]></surname>
<given-names><![CDATA[Maria Patricia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Deviaene]]></surname>
<given-names><![CDATA[Meagan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Keynan]]></surname>
<given-names><![CDATA[Yoav]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rueda]]></surname>
<given-names><![CDATA[Zulma Vanessa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Marin]]></surname>
<given-names><![CDATA[Diana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Secretaría de Salud de Cali Programa de tuberculosis ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad del Cauca Facultad de Ciencias de la Salud ]]></institution>
<addr-line><![CDATA[Popayán ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de Antioquia Facultad Nacional de Salud Pública ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,University of Manitoba Department of Medical Microbiology and Infectious Diseases ]]></institution>
<addr-line><![CDATA[Winnipeg Manitoba]]></addr-line>
<country>Canada</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidad Pontificia Bolivariana School of Medicine ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<volume>52</volume>
<numero>4</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S1657-95342021000404875&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S1657-95342021000404875&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S1657-95342021000404875&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Objective: To determine factors associated with mortality in tuberculosis/HIV co-infected patients in Cali, Colombia  Methods:  This retrospective cohort design included tuberculosis/HIV co-infected persons. Kaplan-Meier and Cox regression were used to estimate survival and risk factors associated with mortality.  Results:  Of the 279 tuberculosis/HIV co-infected participants, 27.2% died during the study. Participants mainly were adults and males. CD4 count information was available for 41.6% (the median count was 83 cells/mm3), and half were subject to tuberculosis susceptibility testing. The median time between HIV diagnosis and antiretroviral therapy initiation was 372 days. HIV was identified prior to tuberculosis in 53% and concurrent HIV-tuberculosis were diagnosed in 37% of patients. 44.8% had tuberculosis treatment success. Body mass index above 18 kg/m2, initiation of tuberculosis treatment within two weeks, having any health insurance coverage and CD4 count information conferred a survival advantage.  Conclusions: Delays in treatment initiation and factors associated with limited health care access or utilization were associated with mortality. As HIV and tuberculosis are both reportable conditions in Colombia, strategies should be focused on optimizing treatment outcomes within both tuberculosis and HIV programs, particularly improving early HIV diagnosis, early antiretroviral therapy treatment initiation, and adherence to tuberculosis treatment.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo:  Determinar factores asociados con mortalidad en personas con co-infeccion Tuberculosis/VIH en Cali, Colombia.  Métodos:  Este diseño de cohorte retrospectiva incluyó personas co-infectadas con tuberculosis /VIH. Se utilizó Kaplan Meier y regresion de Cox para estimar supervivencia y factores de riesgo asociados con mortalidad.  Resultados:  De los 279 participantes coinfectados con tuberculosis/VIH, el 27.2% falleció durante el estudio. Los participantes fueron principalmente adultos y hombres. Se dispuso de información de recuento de CD4 en el 41.6% (la mediana del recuento fue 83 células/mm3), y en la mitad se realizaron pruebas de susceptibilidad para tuberculosis. La mediana de tiempo entre el diagnóstico de VIH e inicio de terapia antirretroviral fue 372 días. Se identificó VIH previo a tuberculosis en un 53%, e infección concurrente tuberculosis-VIH en el 37% de los pacientes. El 44.8% presentó éxito en el tratamiento para tuberculosis. Un índice de masa corporal superior a 18 kg/m2, inicio del tratamiento para TB dentro de las primeras dos semanas, contar con aseguramiento en salud y con recuento de CD4 se asociaron con mayor supervivencia.  Conclusiones:  Retraso en el inicio de tratamiento y factores relacionados con brechas en el acceso a atención en salud se asociaron con mortalidad. Dado que VIH y tuberculosis son enfermedades de notificación obligatoria en Colombia, las estrategias deben centrarse en optimizar los desenlaces del tratamiento dentro de ambos programas, en particular mejorar el diagnóstico temprano de VIH, el inicio temprano de la terapia antirretroviral y fomentar la adherencia al tratamiento para tuberculosis.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Tuberculosis]]></kwd>
<kwd lng="en"><![CDATA[HIV]]></kwd>
<kwd lng="en"><![CDATA[mortality]]></kwd>
<kwd lng="en"><![CDATA[cohort study]]></kwd>
<kwd lng="en"><![CDATA[health services accessibility]]></kwd>
<kwd lng="es"><![CDATA[Tuberculosis]]></kwd>
<kwd lng="es"><![CDATA[VIH]]></kwd>
<kwd lng="es"><![CDATA[mortalidad]]></kwd>
<kwd lng="es"><![CDATA[estudio de cohorte]]></kwd>
<kwd lng="es"><![CDATA[accesibilidad a los servicios de salud]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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