Improved survival in multidrug-resistant tuberculosis patients receiving integrated tuberculosis and antiretroviral treatment in the SAPiT Trial.
Int J Tuberc Lung Dis
; 18(2): 147-54, 2014 Feb.
Article
em En
| MEDLINE
| ID: mdl-24429305
ABSTRACT
BACKGROUND:
The therapeutic effects of antiretroviral treatment (ART) in patients with multidrug-resistant tuberculosis (MDR-TB) and human immunodeficiency virus (HIV) infection have not been established.OBJECTIVE:
To assess therapeutic outcomes of integrating ART with treatment for MDR-TB.DESIGN:
A subgroup of MDR-TB patients from a randomised controlled trial, the SAPiT (Starting Antiretroviral Therapy at Three Points in Tuberculosis) study, conducted in an out-patient clinic in Durban, South Africa, from 2008 to 2012.METHODS:
Clinical outcomes at 18 months were compared in patients randomised to receive ART within 12 weeks of initiating standard first-line anti-tuberculosis treatment with those who commenced ART after completing anti-tuberculosis treatment.RESULTS:
Mycobacterium tuberculosis drug susceptibility results were available in 489 (76%) of 642 SAPiT patients 23 had MDR-TB, 14 in the integrated treatment arm and 9 in the sequential treatment arm. At 18 months, the mortality rate was 11.9/100 person-years (py; 95%CI 1.4-42.8) in the combined integrated treatment arm and 56.0/100 py (95%CI 18.2-130.8) in the sequential treatment arm (hazard ratio adjusted for baseline CD4 count and whether MDR-TB treatment was initiated 0.14; 95%CI 0.02-0.94, P = 0.04).CONCLUSION:
Despite the small sample size, the 86% reduction in mortality due to early initiation of ART in MDR-TB patients was statistically significant.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Tuberculose Resistente a Múltiplos Medicamentos
/
Fármacos Anti-HIV
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Coinfecção
/
Antituberculosos
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Africa
Idioma:
En
Revista:
Int J Tuberc Lung Dis
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
África do Sul