ArticleTropical medicine & international health : TM & IH2013
Initiation of antiretroviral therapy in HIV-infected tuberculosis patients in rural Kenya: an observational study.
Article in Tropical medicine & international health : TM & IH, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- HIV and tuberculosis co-infection in East Asia and the Pacific from 1990 to 2017: results from the Global Burden of Disease Study 2017.Journal of thoracic disease · 2019Article
- Improving survival with tuberculosis & HIV treatment integration: A mini-review.The Indian journal of medical research · 2019Review
- Time to death and risk factors among tuberculosis patients in Northern Ethiopia.BMC research notes · 2018Article
- Mortality among tuberculosis patients under DOTS programme: a historical cohort study.BMC public health · 2016Article
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Authors and funding
5 authors.
Funding
Abstract
objectiveTo provide information on the effect of timing of antiretroviral therapy (ART) initiation on outcomes of TB infection in real-life, non-clinical trial, rural settings in sub-Saharan Africa.
methodsWe conducted an observational cohort study of all HIV-infected TB patients presenting to a rural hospital in Kenya between 2005 and 2009. We analysed the association between timing of initiation of ART and mortality, using a Cox regression survival analysis, adjusted for measured confounders.
resultsA total of 404 antiretroviral-naïve HIV/TB coinfected patients were included in the study. Initiation of ART during the first 8 weeks of TB treatment (early group) was not associated with changes in mortality at 1 year compared with initiation of ART after 8 weeks (late group) [Hazard Ratio (HR) = 0.74 (Confidence Interval (CI), 0.33-1.64, P = 0.46]. In patients with baseline CD4 counts ≤50 cells/μl, there was a significant reduction in mortality in the early group compared with the late group (HR = 0.20; 95% CI, 0.042-0.99; P = 0.049). In patients with a CD4 count >50 cells/μl, there was no significant difference between early and late groups (HR 1.79; 95% CI, 0.64-5.03; P = 0.27).
conclusionsWe found that in HIV/TB coinfected patients in rural Kenya, early ART initiation (within 8 weeks) was associated with reduced mortality in those with CD4 counts ≤50 cells/μl. In patients with CD4 counts >50 cells/μl, there was no association seen between timing of ART and mortality.
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