Early initiation of antiretroviral therapy results in decreased morbidity and mortality among patients with TB and HIV
INTRODUCTION: The overlapping drug toxicity profiles, drug-drug interactions and complications of management of both HIV and tuberculosis (TB) in patients with advanced HIV have not been fully delineated.
METHODS: We conducted a retrospective chart review of the outcomes of tuberculosis treatment among 69 HIV-infected patients with TB, who were hospitalized in Masih Daneshvari Hospital in Tehran, Iran between 2002 and 2006, and who received standard category 1 (CAT-1) regimens. Group I (N = 47) included those treated from 2002 to 2005 with highly active antiretroviral therapy (HAART) initiated after eight weeks of TB treatment for those whose CD4 count was <200 cells/mm3. Group II (N = 22) included TB patients treated from 2005 to 2006, with HAART initiated after two weeks of TB treatment if their CD4 count was <100 cells/mm3 and eight weeks after initiation of TB treatment for those whose CD4 count was between 101 and 200 cells/mm3.
RESULTS: There were no differences between Groups I and II with regard to: adverse drug reactions [four (8.5%) versus two (9%), p = ns]; IRIS [six (12.7%) versus three (10.7%), p = ns]; and new opportunistic infections [eight (17.0%) versus two (9.1%), p = ns]. Death, however, occurred more frequently in Group I than in Group II [13 (27.7%) versus (4.5%), p = 0.03], where HAART was initiated earlier. Injection of drugs was the most common route of HIV transmission in both groups (72.3% in Group I and 77.3% in Group II).
CONCLUSION: This manuscript shows that in a retrospective review of HIV/TB patients hospitalized in Tehran, improved survival was associated with earlier initiation of antiretroviral therapy in HIV/TB patients with CD4 counts of below 100 cells/mm3.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2009 |
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Erschienen: |
2009 |
Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
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Enthalten in: |
Journal of the International AIDS Society - 12(2009) vom: 16. Juli, Seite 14 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Tabarsi, Payam [VerfasserIn] |
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Date Completed 02.10.2012 Date Revised 20.10.2021 published: Electronic Citation Status PubMed-not-MEDLINE |
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doi: |
10.1186/1758-2652-12-14 |
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funding: |
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PPN (Katalog-ID): |
NLM190040777 |
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500 | |a published: Electronic | ||
500 | |a Citation Status PubMed-not-MEDLINE | ||
520 | |a INTRODUCTION: The overlapping drug toxicity profiles, drug-drug interactions and complications of management of both HIV and tuberculosis (TB) in patients with advanced HIV have not been fully delineated | ||
520 | |a METHODS: We conducted a retrospective chart review of the outcomes of tuberculosis treatment among 69 HIV-infected patients with TB, who were hospitalized in Masih Daneshvari Hospital in Tehran, Iran between 2002 and 2006, and who received standard category 1 (CAT-1) regimens. Group I (N = 47) included those treated from 2002 to 2005 with highly active antiretroviral therapy (HAART) initiated after eight weeks of TB treatment for those whose CD4 count was <200 cells/mm3. Group II (N = 22) included TB patients treated from 2005 to 2006, with HAART initiated after two weeks of TB treatment if their CD4 count was <100 cells/mm3 and eight weeks after initiation of TB treatment for those whose CD4 count was between 101 and 200 cells/mm3 | ||
520 | |a RESULTS: There were no differences between Groups I and II with regard to: adverse drug reactions [four (8.5%) versus two (9%), p = ns]; IRIS [six (12.7%) versus three (10.7%), p = ns]; and new opportunistic infections [eight (17.0%) versus two (9.1%), p = ns]. Death, however, occurred more frequently in Group I than in Group II [13 (27.7%) versus (4.5%), p = 0.03], where HAART was initiated earlier. Injection of drugs was the most common route of HIV transmission in both groups (72.3% in Group I and 77.3% in Group II) | ||
520 | |a CONCLUSION: This manuscript shows that in a retrospective review of HIV/TB patients hospitalized in Tehran, improved survival was associated with earlier initiation of antiretroviral therapy in HIV/TB patients with CD4 counts of below 100 cells/mm3 | ||
650 | 4 | |a Journal Article | |
700 | 1 | |a Saber-Tehrani, Ali S |e verfasserin |4 aut | |
700 | 1 | |a Baghaei, Parvaneh |e verfasserin |4 aut | |
700 | 1 | |a Padyab, Mojgan |e verfasserin |4 aut | |
700 | 1 | |a Mansouri, Davood |e verfasserin |4 aut | |
700 | 1 | |a Amiri, Majid |e verfasserin |4 aut | |
700 | 1 | |a Masjedi, Mohammad Reza |e verfasserin |4 aut | |
700 | 1 | |a Altice, Frederick L |e verfasserin |4 aut | |
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