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/$ mm^{3} $. Group II (N = 22) included TB patients treated from 2005 to 2006, with HAART initiated after two weeks of TB treatment if their CD4 count was <100 cells/$ mm^{3} $ and eight weeks after initiation of TB treatment for those whose CD4 count was between 101 and 200 cells/$ mm^{3} $. Results There were no differences between Groups I and II with regard to: adverse drug reactions [four (8.5%) versus two (9%), p = ns]; IRIS [six (12.7%) versus three (10.7%), p = ns]; and new opportunistic infections [eight (17.0%) versus two (9.1%), p = ns]. Death, however, occurred more frequently in Group I than in Group II [13 (27.7%) versus (4.5%), p = 0.03], where HAART was initiated earlier. Injection of drugs was the most common route of HIV transmission in both groups (72.3% in Group I and 77.3% in Group II). Conclusion This manuscript shows that in a retrospective review of HIV/TB patients hospitalized in Tehran, improved survival was associated with earlier initiation of antiretroviral therapy in HIV/TB patients with CD4 counts of below 100 cells/$ mm^{3} $..
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2009 |
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Erschienen: |
2009 |
Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
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Enthalten in: |
Journal of the International AIDS Society - 12(2009), 1 vom: 16. Juli |
Sprache: |
Englisch |
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Beteiligte Personen: |
Tabarsi, Payam [VerfasserIn] |
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Links: |
Volltext [kostenfrei] |
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Themen: |
Drug Susceptibility Test |
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Anmerkungen: |
© Tabarsi et al. 2009 |
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doi: |
10.1186/1758-2652-12-14 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
OLC2098250819 |
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520 | |a Introduction The overlapping drug toxicity profiles, drug-drug interactions and complications of management of both HIV and tuberculosis (TB) in patients with advanced HIV have not been fully delineated. Methods We conducted a retrospective chart review of the outcomes of tuberculosis treatment among 69 HIV-infected patients with TB, who were hospitalized in Masih Daneshvari Hospital in Tehran, Iran between 2002 and 2006, and who received standard category 1 (CAT-1) regimens. Group I (N = 47) included those treated from 2002 to 2005 with highly active antiretroviral therapy (HAART) initiated after eight weeks of TB treatment for those whose CD4 count was <200 cells/$ mm^{3} $. Group II (N = 22) included TB patients treated from 2005 to 2006, with HAART initiated after two weeks of TB treatment if their CD4 count was <100 cells/$ mm^{3} $ and eight weeks after initiation of TB treatment for those whose CD4 count was between 101 and 200 cells/$ mm^{3} $. Results There were no differences between Groups I and II with regard to: adverse drug reactions [four (8.5%) versus two (9%), p = ns]; IRIS [six (12.7%) versus three (10.7%), p = ns]; and new opportunistic infections [eight (17.0%) versus two (9.1%), p = ns]. Death, however, occurred more frequently in Group I than in Group II [13 (27.7%) versus (4.5%), p = 0.03], where HAART was initiated earlier. Injection of drugs was the most common route of HIV transmission in both groups (72.3% in Group I and 77.3% in Group II). Conclusion This manuscript shows that in a retrospective review of HIV/TB patients hospitalized in Tehran, improved survival was associated with earlier initiation of antiretroviral therapy in HIV/TB patients with CD4 counts of below 100 cells/$ mm^{3} $. | ||
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