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 |
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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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