TY - JOUR
T1 - Early initiation of antiretroviral therapy results in decreased morbidity and mortality among patients with TB and HIV
AU - Tabarsi, Payam
AU - Saber-Tehrani, Ali S.
AU - Baghaei, Parvaneh
AU - Padyab, Mojgan
AU - Mansouri, Davood
AU - Amiri, Majid
AU - Masjedi, Mohammad Reza
AU - Altice, Frederick L.
N1 - Publisher Copyright:
© 2009 Tabarsi et al; licensee BioMed Central Ltd.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2009/2
Y1 - 2009/2
N2 - Introduction: The overlapping drug toxicity profiles, drug-drug interactions and complications of management of both HIV and tuberculosis (TB) in patients with advanced HIV have not been fully delineated. Methods: We conducted a retrospective chart review of the outcomes of tuberculosis treatment among 69 HIV-infected patients with TB, who were hospitalized in Masih Daneshvari Hospital in Tehran, Iran between 2002 and 2006, and who received standard category 1 (CAT-1) regimens. Group I (N = 47) included those treated from 2002 to 2005 with highly active antiretroviral therapy (HAART) initiated after eight weeks of TB treatment for those whose CD4 count was <200 cells/ mm3. Group II (N = 22) included TB patients treated from 2005 to 2006, with HAART initiated after two weeks of TB treatment if their CD4 count was <100 cells/mm3 and eight weeks after initiation of TB treatment for those whose CD4 count was between 101 and 200 cells/mm3. Results: There were no differences between Groups I and II with regard to: adverse drug reactions [four (8.5%) versus two (9%), p = ns]; IRIS [six (12.7%) versus three (10.7%), p = ns]; and new opportunistic infections [eight (17.0%) versus two (9.1%), p = ns]. Death, however, occurred more frequently in Group I than in Group II [13 (27.7%) versus (4.5%), p = 0.03], where HAART was initiated earlier. Injection of drugs was the most common route of HIV transmission in both groups (72.3% in Group I and 77.3% in Group II). Conclusion: This manuscript shows that in a retrospective review of HIV/TB patients hospitalized in Tehran, improved survival was associated with earlier initiation of antiretroviral therapy in HIV/ TB patients with CD4 counts of below 100 cells/mm3.
AB - Introduction: The overlapping drug toxicity profiles, drug-drug interactions and complications of management of both HIV and tuberculosis (TB) in patients with advanced HIV have not been fully delineated. Methods: We conducted a retrospective chart review of the outcomes of tuberculosis treatment among 69 HIV-infected patients with TB, who were hospitalized in Masih Daneshvari Hospital in Tehran, Iran between 2002 and 2006, and who received standard category 1 (CAT-1) regimens. Group I (N = 47) included those treated from 2002 to 2005 with highly active antiretroviral therapy (HAART) initiated after eight weeks of TB treatment for those whose CD4 count was <200 cells/ mm3. Group II (N = 22) included TB patients treated from 2005 to 2006, with HAART initiated after two weeks of TB treatment if their CD4 count was <100 cells/mm3 and eight weeks after initiation of TB treatment for those whose CD4 count was between 101 and 200 cells/mm3. Results: There were no differences between Groups I and II with regard to: adverse drug reactions [four (8.5%) versus two (9%), p = ns]; IRIS [six (12.7%) versus three (10.7%), p = ns]; and new opportunistic infections [eight (17.0%) versus two (9.1%), p = ns]. Death, however, occurred more frequently in Group I than in Group II [13 (27.7%) versus (4.5%), p = 0.03], where HAART was initiated earlier. Injection of drugs was the most common route of HIV transmission in both groups (72.3% in Group I and 77.3% in Group II). Conclusion: This manuscript shows that in a retrospective review of HIV/TB patients hospitalized in Tehran, improved survival was associated with earlier initiation of antiretroviral therapy in HIV/ TB patients with CD4 counts of below 100 cells/mm3.
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U2 - 10.1186/1758-2652-12-14
DO - 10.1186/1758-2652-12-14
M3 - Article
AN - SCOPUS:84904737592
VL - 12
JO - Journal of the International AIDS Society
JF - Journal of the International AIDS Society
SN - 1758-2652
IS - 1
M1 - 14
ER -