ArticlePloS one2014
Cotrimoxazole prophylaxis and tuberculosis risk among people living with HIV.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 3 syntheses or guidelines pooled it, 17 citations in OpenAlex.
- Mortality and associated factors among patients with TB-HIV co-infection in Ethiopia: a systematic review and meta-analysis.BMC infectious diseases · 2024Pooled it
- Effects of undernutrition on mortality and morbidity among adults living with HIV in sub-Saharan Africa: a systematic review and meta-analysis.BMC infectious diseases · 2021Pooled it
- Assessment of the impact of cotrimoxazole prophylaxis on key outcomes among HIV-infected adults in low- and middle-income countries: a systematic review.Journal of acquired immune deficiency syndromes (1999) · 2015Pooled it
- Prevalence and associated factors of tuberculosis among isoniazid users and non-users of HIV patients in Dessie, Ethiopia.Scientific reports · 2022Article
- Central Nervous System Tuberculosis (CNS-TB) in treated HIV-infected adults in Tikur Anbessa Specialized Hospital, Ethiopia: A cross sectional study.Journal of clinical tuberculosis and other mycobacterial diseases · 2021Article
- Cotrimoxazole prophylaxis decreases tuberculosis risk among Asian patients with HIV.Journal of the International AIDS Society · 2019Observational
- Getting to 90-90-90 in paediatric HIV: What is needed?Journal of the International AIDS Society · 2015Article
- Tuberculosis: opportunities and challenges for the 90-90-90 targets in HIV-infected children.Journal of the International AIDS Society · 2015Review
- Co-trimoxazole prophylaxis is associated with reduced risk of incident tuberculosis in participants in the Swiss HIV Cohort Study.Antimicrobial agents and chemotherapy · 2014Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 2 countries.
Funding
Abstract
objectivesMany randomized and cohort studies have reported a survival benefit with cotrimoxazole prophylaxis without detecting a difference in tuberculosis (TB) incidence by cotrimoxazole status. However, several in vitro studies have reported that cotrimoxazole possesses anti-TB activity. We sought to compare TB incidence and TB diagnostic yield by cotrimoxazole use among participants in a well characterized cohort of HIV-infected adults living in a high TB prevalence region.
methodsWe analyzed prospective data from a long-term longitudinal cohort of adults receiving HIV care and TB investigations in Soweto, South Africa. Using longitudinal analysis, we compared total and laboratory confirmed TB incidence by cotrimoxazole status as well as all-cause mortality. In addition, we compared TB culture results by cotrimoxazole status.
resultsIn a multivariable analysis, adjusted for sex, body mass index, WHO clinical stage, time-updated CD4 count, and antiretroviral therapy status, we observed an association between cotrimoxazole and an increase in TB incidence (hazard ratio 1.7, 95% CI: 1.2, 2.2). However, when restricted to laboratory-confirmed TB, there was no association between cotrimoxazole and TB incidence (hazard ratio: 0.97, 95% CI: 0.39, 2.4). In TB cases, we found no difference in the proportion of positive sputum cultures or days to culture positivity by cotrimoxazole status. Cotrimoxazole was associated with a reduction in mortality.
conclusionsIn this cohort with a mortality benefit from cotrimoxazole, we found an increased risk of all TB among individuals using cotrimoxazole, likely a result of residual confounding, but no association between use of cotrimoxazole and laboratory-confirmed TB. Cotrimoxazole did not compromise TB diagnosis.
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