Completion of isoniazid preventive therapy and survival in HIV-infected, TST-positive adults in Tanzania

Autor: Conrad Kabali, Robert D. Arbeit, Lillian Mtei, Richard Waddell, C. R. Horsburgh, Kisali Pallangyo, Daniel R. Brooks, Mecky Matee, C. F. von Reyn, Muhammad Bakari
Rok vydání: 2011
Předmět:
Male
Time Factors
Antitubercular Agents
HIV Infections
Kaplan-Meier Estimate
Tanzania
law.invention
Randomized controlled trial
Risk Factors
law
Medicine
Prospective Studies
Young adult
Tuberculosis Vaccines
Prospective cohort study
Coinfection
Incidence
Incidence (epidemiology)
Middle Aged
Treatment Outcome
Infectious Diseases
Practice Guidelines as Topic
Cohort
Female
Cohort study
Adult
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Tuberculosis
Anti-HIV Agents
World Health Organization
Risk Assessment
Drug Administration Schedule
Young Adult
Tuberculosis diagnosis
Predictive Value of Tests
Internal medicine
parasitic diseases
Isoniazid
Humans
Aged
Proportional Hazards Models
AIDS-Related Opportunistic Infections
Tuberculin Test
business.industry
medicine.disease
CD4 Lymphocyte Count
Physical therapy
business
Zdroj: The International Journal of Tuberculosis and Lung Disease. 15:1515-1522
ISSN: 1027-3719
Popis: Setting The World Health Organization recommends the use of isoniazid preventive therapy (IPT) for human immunodeficiency virus (HIV) infected patients with a positive tuberculin skin test (TST). However, due to concerns about the effectiveness of IPT in community health care settings and the development of drug resistance, these recommendations have not been widely implemented in countries where tuberculosis (TB) and HIV co-infection is common. Objective To evaluate the effectiveness of IPT on survival and TB incidence among HIV-infected patients in Tanzania. Design A cohort study nested within a randomized trial of HIV-infected adults with baseline CD4 counts of ≥ 200 cells/μ l was conducted to compare survival and incidence of active TB between TST-positive subjects who did or did not complete 6 months of IPT in the period 2001-2008. Results Of 558 TST-positive subjects in the analytic cohort, 488 completed 6 months of IPT and 70 did not. Completers had a decrease in mortality compared to non-completers (HR 0.4, 95%CI 0.2-0.8). However, the protective effect of IPT on the incidence of active TB was non-significant (HR 0.6, 95%CI 0.3-1.3). Conclusion Completion of IPT is associated with increased survival in HIV-infected adults with CD4 counts ≥ 200 cells/μ l and a positive TST.
Databáze: OpenAIRE
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