A randomized trial of punctuated antiretroviral therapy in Ugandan HIV-seropositive adults with pulmonary tuberculosis and CD4⺠T-cell counts of ≥ 350 cells/µL.
J Infect Dis
; 204(6): 884-92, 2011 Sep 15.
Article
en En
| MEDLINE
| ID: mdl-21849285
ABSTRACT
BACKGROUND:
Optimal treatment of human immunodeficiency virus (HIV)-associated tuberculosis in patients with high CD4⺠T-cell counts is unknown. Suppression of viral replication during therapy for tuberculosis may block effects of immune activation on T cells and slow HIV disease progression.METHODS:
We conducted a randomized trial in 214 HIV-infected patients with active tuberculosis and CD4⺠T-cell counts of ≥ 350 cells/µL to determine whether 6 months of antiretroviral therapy given during tuberculosis treatment would improve clinical outcomes. Subjects were randomized to receive 6 months of abacavir-lamivudine-zidovudine concurrent with tuberculosis therapy or delayed antiretroviral therapy. Endpoints were CD4⺠T-cell counts of < 250 cells/µL, AIDS, or death.RESULTS:
Intervention and comparison arms had similar median CD4⺠counts (517 and 534 cells/µL, respectively) and HIV RNA levels (4.6 and 4.7 log10 copies/µL, respectively). Viral suppression was achieved in 86% of patients allocated to intervention. Seventeen subjects (15.6%) in the intervention arm developed study outcome compared to 25 subjects (22.8%) in the comparison arm (P = .17). Grade 3 or 4 adverse events were less frequent in the intervention arm. By 2 months, 90% of subjects in both arms were culture-negative for tuberculosis.CONCLUSIONS:
Short-term antiretroviral therapy during tuberculosis treatment in patients with CD4âºT-cell counts of >350 cells/µL was safe and associated with clinical benefits.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Tuberculosis Pulmonar
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Linfocitos T CD4-Positivos
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Infecciones por VIH
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Fármacos Anti-VIH
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Terapia Antirretroviral Altamente Activa
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Antituberculosos
Tipo de estudio:
Clinical_trials
Límite:
Adolescent
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Adult
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Female
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Humans
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Male
/
Middle aged
País/Región como asunto:
Africa
Idioma:
En
Revista:
J Infect Dis
Año:
2011
Tipo del documento:
Article
País de afiliación:
Uganda