Publication: Treatment outcomes of patients co-infected with HIV and tuberculosis who received a nevirapine-based antiretroviral regimen: A four-year prospective study
Issued Date
2010-11-01
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ISSN
12019712
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2-s2.0-78149468114
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Mahidol University
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SCOPUS
Bibliographic Citation
International Journal of Infectious Diseases. Vol.14, No.11 (2010)
Suggested Citation
Weerawat Manosuthi, Preecha Tantanathip, Sukanya Chimsuntorn, Boonchuay Eampokarap, Supeda Thongyen, Samruay Nilkamhang, Somnuek Sungkanuparph Treatment outcomes of patients co-infected with HIV and tuberculosis who received a nevirapine-based antiretroviral regimen: A four-year prospective study. International Journal of Infectious Diseases. Vol.14, No.11 (2010). doi:10.1016/j.ijid.2010.06.016 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/29479
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Title
Treatment outcomes of patients co-infected with HIV and tuberculosis who received a nevirapine-based antiretroviral regimen: A four-year prospective study
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Abstract
Background: The concurrent use of nevirapine-based antiretroviral therapy (ART) and rifampin-containing anti-tuberculosis regimens for the treatment of HIV and tuberculosis (TB) is common in resource-limited countries. Long-term outcomes of this concurrent treatment are unknown. Methods: Seventy HIV-infected patients receiving rifampin for active TB (TB group) and 70 HIV-mono-infected patients (control group) were enrolled to receive nevirapine 400. mg/day-based ART. All were followed through 4 years of ART. Plasma HIV-1 RNA and CD4 cell counts were monitored every 12 weeks until 96 weeks, and every 24 weeks thereafter. Results: Of the 140 patients, the median (interquartile range (IQR)) CD4 count was 31 (14-79) cells/mm3and median (IQR) plasma HIV-1 RNA was 5.6 (5.2-5.9) log copies/ml at baseline Thirty-nine (55.7%) patients in the TB group were diagnosed with extrapulmonary/disseminated TB. The median duration of concurrent administration of nevirapine and rifampin was 5.4 (4.6-6.1) months. By intention-to-treat analysis, the percentage of patients who achieved HIV-1 RNA <50 copies/ml was 52.9% in the TB group and 50% in control group (p=0.866; odds ratio 1.121, 95% confidence interval 0.578-2.176); median (IQR) CD4 counts were 352 (271-580) cells/mm3and 425 (308-615) cells/mm3in the corresponding groups (p=0.238). The proportion of ART discontinuation due to any reason at 1, 2, 3, and 4 years was 21%, 34%, 37%, and 46% in the TB group and 21%, 36%, 43%, and 49% in the control group, respectively (p=0.651). The 4-year mortality rate was 6.4% in both groups. Conclusions: Nevirapine-based ART is an option for HIV-infected patients who receive rifampin in resource-limited countries or those who cannot tolerate efavirenz. © 2010 International Society for Infectious Diseases.