| Outcome of HIV-associated tuberculosis in the era of highly active antiretroviral therapy. | |
| | |
MedLine Citation:
|
PMID: 15478074 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: The benefit of highly active antiretroviral therapy (HAART) in the treatment of patients coinfected with tuberculosis (TB) and human immunodeficiency virus (HIV) is unclear because of concerns about treatment-related complications. METHODS: We compared outcomes in patients starting TB treatment during the pre-HAART era (before 1996; n=36) with those in patients starting treatment during the HAART era (during or after 1996; n=60). RESULTS: During a median of 3.6 years of follow-up, 49 patients died or had an AIDS event. Compared with patients in the pre-HAART group, those in the HAART group had a lower risk of death (cumulative at 4 years, 43% vs. 22%; P=.012) and of death or having an AIDS event (69% vs. 43%; P=.023). Event risk within the first 2 months of TB treatment was exceptionally high in patients with CD4(+) cell counts <100 cells/mm(3) and declined thereafter. HAART use during follow-up was associated with a marked reduction in event risk (adjusted hazard ratio, 0.38 [95% confidence interval, 0.16-0.91]). CONCLUSIONS: HAART substantially reduces new AIDS events and death in coinfected patients. Those with a CD4(+) cell count <100 cells/mm(3) have a high event risk during the intensive phase of anti-TB treatment. These data should be taken into account when deciding to delay HAART in coinfected patients with CD4(+) cell counts <100 cells/mm(3). |
| | |
Authors:
|
Keertan Dheda; Fiona C Lampe; Margaret A Johnson; Marc C Lipman |
Related Documents
:
|
11246614 - Treatment with interferon-alpha2b of naive non-cirrhotic patients with chronic hepatiti... 20415574 - Early versus delayed initiation of antiretroviral therapy for concurrent hiv infection ... 12044534 - Daily or three times per week interferon alpha-2b in combination with ribavirin or inte... 7906384 - A comparative trial of didanosine or zalcitabine after treatment with zidovudine in pat... 17395864 - A novel, self-expanding, nitinol stent in medically refractory intracranial atheroscler... 15531974 - Treatment of severe chronic venous insufficiency using the subfascial endoscopic perfor... |
Publication Detail:
|
Type: Comparative Study; Journal Article Date: 2004-09-29 |
Journal Detail:
|
Title: The Journal of infectious diseases Volume: 190 ISSN: 0022-1899 ISO Abbreviation: J. Infect. Dis. Publication Date: 2004 Nov |
Date Detail:
|
Created Date: 2004-10-12 Completed Date: 2004-11-30 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0413675 Medline TA: J Infect Dis Country: United States |
Other Details:
|
Languages: eng Pagination: 1670-6 Citation Subset: AIM; IM |
Affiliation:
|
Department of Thoracic and HIV Medicine, Royal Free Hospital, Royal Free and University College London Medical School, London, United Kingdom. k.dheda@ucl.ac.uk. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
AIDS-Related Opportunistic Infections
/
drug therapy Adult Antiretroviral Therapy, Highly Active* Antitubercular Agents / adverse effects, therapeutic use* CD4 Lymphocyte Count Female HIV Infections / complications*, drug therapy*, mortality Humans London Male Middle Aged Risk Assessment Treatment Outcome Tuberculosis / complications*, drug therapy*, microbiology, mortality |
| Chemical | |
Reg. No./Substance:
|
0/Antitubercular Agents |
| Comments/Corrections | |
Comment In:
|
J Infect Dis. 2005 Nov 1;192(9):1673-4; author reply 1674-5
[PMID:
16206087
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Tissue-specific contributions of pneumococcal virulence factors to pathogenesis.
Next Document: Does tuberculosis increase HIV load?