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Title: Prognostic significance of the interval between the initiation of antiretroviral therapy and the initiation of anti-tuberculosis treatment in HIV/tuberculosis-coinfected patients: Results from the TREAT Asia HIV Observational Database
Authors: S. H. Han
J. Zhou
M. P. Lee
H. Zhao
Y. M.A. Chen
N. Kumarasamy
S. Pujari
C. Lee
S. F.S. Omar
R. Ditangco
N. Phanuphak
S. Kiertiburanakul
R. Chaiwarith
T. P. Merati
E. Yunihastuti
J. Tanuma
V. Saphonn
A. H. Sohn
J. Y. Choi
C. V. Mean
V. Saphonn
K. Vohith
F. J. Zhang
H. X. Zhao
N. Han
P. C.K. Li
M. P. Lee
N. Kumarasamy
S. Saghayam
C. Ezhilarasi
S. Pujari
K. Joshi
A. Makane
D. N. Wirawan
F. Yuliana
E. Yunihastuti
D. Imran
A. Widhani
S. Oka
J. Tanuma
T. Nishijima
J. Y. Choi
S. H. Han
J. M. Kim
C. K.C. Lee
B. L.H. Sim
R. David
A. Kamarulzaman
A. Kajindran
R. Ditangco
E. Uy
R. Bantique
Y. M.A. Chen
W. W. Wong
L. H. Kuo
O. T. Ng
A. Chua
L. S. Lee
A. Loh
P. Phanuphak
K. Ruxrungtham
M. Khongphattanayothin
S. Sungkanuparph
N. Sanmeema
T. Sirisanthana
R. Chaiwarith
W. Kotarathititum
V. K. Nguyen
V. H. Bui
T. T. Cao
T. T. Pham
D. D. Cuong
H. L. Ha
A. H. Sohn
N. Durier
D. A. Cooper
B. Petersen
J. Zhou
A. Jiamsakul
Yonsei University College of Medicine
University of New South Wales (UNSW) Australia
Queen Elizabeth Hospital Hong Kong
Beijing Ditan Hospital
National Yang-Ming University Taiwan
YR Gaitonde Centre for AIDS Research and Education
Institute of Infectious Diseases
Hospital Sungai Buloh
University of Malaya Medical Centre
The HIV Netherlands Australia Thailand Research Collaboration
Mahidol University
Research Institute for Health Sciences
Universitas Udayana
University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
National Center for Global Health and Medicine
National Center for HIV/AIDS
Foundation for AIDS Research
Tan Tock Seng Hospital
National Hospital for Tropical Diseases
Bach Mai Hospital
amfAR - The Foundation for AIDS Research
Keywords: Medicine
Issue Date: 1-Feb-2014
Citation: HIV Medicine. Vol.15, No.2 (2014), 77-85
Abstract: Objectives: We evaluated the effect of the time interval between the initiation of antiretroviral therapy (ART) and the initiation of tuberculosis (TB) treatment on clinical outcomes in HIV/TB-coinfected patients in an Asian regional cohort. Methods: Adult HIV/TB-coinfected patients in an observational HIV-infected cohort database who had a known date of ART initiation and a history of TB treatment were eligible for study inclusion. The time interval between the initiation of ART and the initiation of TB treatment was categorized as follows: TB diagnosed while on ART, ART initiated ≤90 days after initiation of TB treatment ('early ART'), ART initiated >90 days after initiation of TB treatment ('delayed ART'), and ART not started. Outcomes were assessed using survival analyses. Results: A total of 768 HIV/TB-coinfected patients were included in this study. The median CD4 T-cell count at TB diagnosis was 100 [interquartile range (IQR) 40-208] cells/μL. Treatment outcomes were not significantly different between the groups with early ART and delayed ART initiation. Kaplan-Meier analysis indicated that mortality was highest for those diagnosed with TB while on ART (3.77 deaths per 100 person-years), and the prognoses of other groups were not different (in deaths per 100 person-years: 2.12 for early ART, 1.46 for delayed ART, and 2.94 for ART not started). In a multivariate model, the interval between ART initiation and TB therapy initiation did not significantly impact all-cause mortality. Conclusions: A negative impact of delayed ART in patients coinfected with TB was not observed in this observational cohort of moderately to severely immunosuppressed patients. The broader impact of earlier ART initiation in actual clinical practice should be monitored more closely. © 2013 British HIV Association.
ISSN: 14681293
Appears in Collections:Scopus 2011-2015

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