Document Detail


Safety and effectiveness of HAART in tuberculosis-HIV co-infected patients in Brazil.
MedLine Citation:
PMID:  23317954     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Antiretroviral therapy (ART) significantly reduces tuberculosis (TB) incidence among persons with human immunodeficiency virus (HIV), but the safety and effectiveness of concomitant treatment for both diseases remain unclear.
OBJECTIVE: To evaluate the impact of ART and anti-tuberculosis treatment on survival and risk of adverse events (AE) among co-infected individuals.
METHODS: In a retrospective cohort study, clinical data were collected from 618 TB-HIV patients treated with rifampin, isoniazid and pyrazinamide ± ethambutol between 1 January 1995 and 31 December 2003. Patients were categorized into two groups: highly active ART (HAART) or no ART. Different HAART regimens were evaluated. Bivariate analysis, multivariate logistic regression and survival analysis using Cox proportional hazards regression were used.
RESULTS: One-year mortality was lower for patients receiving HAART (adjusted hazard ratio [aHR] 0.17, 95%CI 0.09-0.31) compared to no ART. HAART increased the risk of AE (aHR 2.08, 95%CI 1.29-3.36). The odds of AE when receiving a ritonavir + saquinavir HAART regimen was eight-fold higher compared to no ART (OR 8.31, 95%CI 3.04-22.69), while efavirenz-based HAART was not associated with a significantly increased risk of AE (OR 1.42, 95%CI 0.76-2.65).
CONCLUSION: HIV patients with TB have significantly better survival if they receive HAART during anti-tuberculosis treatment. Efavirenz-based HAART is associated with fewer AEs than protease inhibitor-based HAART.
Authors:
A P G dos Santos; A G Pacheco; A Staviack; J E Golub; R E Chaisson; V C Rolla; A L Kritski; S R L Passos; F C de Queiroz Mello
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease     Volume:  17     ISSN:  1815-7920     ISO Abbreviation:  Int. J. Tuberc. Lung Dis.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-15     Completed Date:  2013-07-02     Revised Date:  2014-02-04    
Medline Journal Info:
Nlm Unique ID:  9706389     Medline TA:  Int J Tuberc Lung Dis     Country:  France    
Other Details:
Languages:  eng     Pagination:  192-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-HIV Agents / therapeutic use*
Antiretroviral Therapy, Highly Active / methods
Antitubercular Agents / therapeutic use*
Brazil / epidemiology
Coinfection / complications,  drug therapy*,  epidemiology
Drug Therapy, Combination
Female
Follow-Up Studies
HIV Infections / complications,  drug therapy*,  epidemiology
Humans
Incidence
Male
Retrospective Studies
Risk Factors
Survival Rate / trends
Treatment Outcome
Tuberculosis / complications,  drug therapy,  epidemiology
Grant Support
ID/Acronym/Agency:
AI001637/AI/NIAID NIH HHS; AI066994/AI/NIAID NIH HHS; U2R TW006883/TW/FIC NIH HHS; U2R TW006885/TW/FIC NIH HHS; U2RTW006883-02//PHS HHS; U2RTW006885//PHS HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/Antitubercular Agents
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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