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Title: Cotrimoxazole prophylaxis decreases tuberculosis risk among Asian patients with HIV
Authors: Stephane Wen Wei Ku
Awachana Jiamsakul
Kedar Joshi
Mark Kristoffer Ungos Pasayan
Alvina Widhani
Romanee Chaiwarith
Sasisopin Kiertiburanakul
Anchalee Avihingsanon
Penh Sun Ly
Nagalingeswaran Kumarasamy
Cuong D. Do
Tuti P. Merati
Kinh Van Nguyen
Adeeba Kamarulzaman
Fujie Zhang
Man Po Lee
Jun Yong Choi
Junko Tanuma
Suwimon Khusuwan
Benedict Lim Heng Sim
Oon Tek Ng
Winai Ratanasuwan
Jeremy Ross
Wing Wai Wong
P. S. Ly
V. Khol
F. J. Zhang
H. X. Zhao
N. Han
M. P. Lee
P. C.K. Li
W. Lam
Y. T. Chan
N. Kumarasamy
S. Saghayam
C. Ezhilarasi
S. Pujari
K. Joshi
S. Gaikwad
A. Chitalikar
S. Sangle
V. Mave
I. Marbaniang
D. N. Wirawan
F. Yuliana
E. Yunihastuti
D. Imran
J. Tanuma
S. Oka
T. Nishijima
J. Y. Choi
S. Na
J. M. Kim
B. L.H. Sim
Y. M. Gani
N. B. Rudi
A. Kamarulzaman
S. F. Syed Omar
S. Ponnampalavanar
I. Azwa
R. Ditangco
M. L. Mationg
W. W. Wong
S. W.W. Ku
P. C. Wu
O. T. Ng
P. L. Lim
L. S. Lee
Z. Ferdous
A. vihingsanon
S. Gatechompol
P. Phanuphak
C. Phadungphon
S. Kiertiburanakul
A. Phuphuakrat
L. Chumla
N. Sanmeema
T. Sirisanthana
W. Kotarathititum
J. Praparattanapan
P. Kantipong
P. Kambua
W. Ratanasuwan
R. Sriondee
K. V. Nguyen
H. V. Bui
D. T.H. Nguyen
D. T. Nguyen
C. D. Do
A. V. Ngo
L. T. Nguyen
A. H. Sohn
J. L. Ross
B. Petersen
D. A. Cooper
M. G. Law
Hospital Sungai Buloh
Beijing Ditan Hospital Capital Medical University
VHS Medical Centre India
Bach Mai Hospital
Universitas Udayana
University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
Chulalongkorn University
Taipei City Hospital Taiwan
Kirby Institute
National Center for Global Health and Medicine
Yonsei University College of Medicine
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Queen Elizabeth Hospital Hong Kong
University of Malaya Medical Centre
Veterans General Hospital-Taipei
Faculty of Medicine, Siriraj Hospital, Mahidol University
Tan Tock Seng Hospital
Chiang Mai University
Dermatology & STDs and University of Health Sciences
National Hospital for Tropical Diseases
Foundation for AIDS Research
Institute of Infectious Diseases
Chiangrai Prachanukroh Hospital
Keywords: Medicine
Issue Date: 1-Mar-2019
Citation: Journal of the International AIDS Society. Vol.22, No.3 (2019)
Abstract: © 2019 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of the International AIDS Society. Introduction: Cotrimoxazole (CTX) is recommended as prophylaxis against Pneumocystis jiroveci pneumonia, malaria and other serious bacterial infections in HIV-infected patients. Despite its in vitro activity against Mycobacterium tuberculosis, the effects of CTX preventive therapy on tuberculosis (TB) remain unclear. Methods: Adults living with HIV enrolled in a regional observational cohort in Asia who had initiated combination antiretroviral therapy (cART) were included in the analysis. Factors associated with new TB diagnoses after cohort entry and survival after cART initiation were analysed using Cox regression, stratified by site. Results: A total of 7355 patients from 12 countries enrolled into the cohort between 2003 and 2016 were included in the study. There were 368 reported cases of TB after cohort entry with an incidence rate of 0.99 per 100 person-years (/100 pys). Multivariate analyses adjusted for viral load (VL), CD4 count, body mass index (BMI) and cART duration showed that CTX reduced the hazard for new TB infection by 28% (HR 0.72, 95% CI l 0.56, 0.93). Mortality after cART initiation was 0.85/100 pys, with a median follow-up time of 4.63 years. Predictors of survival included age, female sex, hepatitis C co-infection, TB diagnosis, HIV VL, CD4 count and BMI. Conclusions: CTX was associated with a reduction in the hazard for new TB infection but did not impact survival in our Asian cohort. The potential preventive effect of CTX against TB during periods of severe immunosuppression should be further explored.
ISSN: 17582652
Appears in Collections:Scopus 2019

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