ArticleBMC infectious diseases2012
Early versus delayed initiation of antiretroviral therapy for Indian HIV-Infected individuals with tuberculosis on antituberculosis treatment.
Article in BMC infectious diseases, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 4 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 4 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- What is the optimum time to start antiretroviral therapy in people with HIV and tuberculosis coinfection? A systematic review and meta-analysis.Journal of the International AIDS Society · 2021Pooled it
- Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016Guideline
- Pooled it
- Pooled it
- Trial
- Factors influencing TB treatment interruption and treatment outcomes among patients in Kiambu County, 2016-2019.PloS one · 2021Article
- Association of CD4 T cell count and optimal timing of antiretroviral therapy initiation with immune reconstitution inflammatory syndrome and all-cause mortality for HIV-infected adults with newly diagnosed pulmonary tuberculosis: a systematic review and meta-analysis.International journal of clinical and experimental pathology · 2021Review
- Tuberculosis IRIS: Pathogenesis, Presentation, and Management across the Spectrum of Disease.Life (Basel, Switzerland) · 2020Review
- Effects of time of initiation of antiretroviral therapy in the treatment of patients with HIV/TB co-infection: A systemic review and meta-analysis.Annals of medicine and surgery (2012) · 2020Review
- Improving survival with tuberculosis & HIV treatment integration: A mini-review.The Indian journal of medical research · 2019Review
- Opportunistic diseases diminish the clinical benefit of immediate antiretroviral therapy in HIV-tuberculosis co-infected adults with low CD4+ cell counts.AIDS (London, England) · 2018Article
- Combination antiretroviral therapy accelerates immune recovery in patients with HIV-related lymphoma treated with EPOCH: a comparison within one prospective trial AMC034.Leukemia & lymphoma · 2018Article
- Immune reconstitution inflammatory syndrome in HIV infection: taking the bad with the good.Oral diseases · 2017Review
- Article
- Risk Factors Associated with the Development of Tuberculosis Among HIV-Infected Patients in Khartoum in 2010.AIMS public health · 2015Article
- The impact of HAART initiation timing on HIV-TB co-infected patients, a retrospective cohort study.BMC infectious diseases · 2014Article
- Review
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFor antiretroviral therapy (ART) naive human immunodeficiency virus (HIV) infected adults suffering from tuberculosis (TB), there is uncertainty about the optimal time to initiate highly active antiretroviral therapy (HAART) after starting antituberculosis treatment (ATT), in order to minimize mortality, HIV disease progression, and adverse events.
methodsIn a randomized, open label trial at All India Institute of Medical Sciences, New Delhi, India, eligible HIV positive individuals with a diagnosis of TB were randomly assigned to receive HAART after 2-4 or 8-12 weeks of starting ATT, and were followed for 12 months after HAART initiation. Participants received directly observed therapy short course (DOTS) for TB, and an antiretroviral regimen comprising stavudine or zidovudine, lamivudine, and efavirenz. Primary end points were death from any cause, and progression of HIV disease marked by failure of ART.
findingsA total of 150 patients with HIV and TB were initiated on HAART: 88 received it after 2-4 weeks (early ART) and 62 after 8-12 weeks (delayed ART) of starting ATT. There was no significant difference in mortality between the groups after the introduction of HAART. However, incidence of ART failure was 31% in delayed versus 16% in early ART arm (p = 0.045). Kaplan Meier disease progression free survival at 12 months was 79% for early versus 64% for the delayed ART arm (p = 0.05). Rates of adverse events were similar.
interpretationEarly initiation of HAART for patients with HIV and TB significantly decreases incidence of HIV disease progression and has good tolerability.
trial registrationCTRI/2011/12/002260.
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