TITLE

Comparison of Treatment Outcomes of New Smear-Positive Pulmonary Tuberculosis Patients by HIV and Antiretroviral Status in a TB/HIV Clinic, Malawi

AUTHOR(S)
Tweya, Hannock; Feldacker, Caryl; Phiri, Sam; Ben-Smith, Anne; Fenner, Lukas; Jahn, Andreas; Kalulu, Mike; Weigel, Ralf; Kamba, Chancy; Banda, Rabecca; Egger, Matthias; Keiser, Olivia
PUB. DATE
February 2013
SOURCE
PLoS ONE;Feb2013, Vol. 8 Issue 2, p1
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Smear-positive pulmonary TB is the most infectious form of TB. Previous studies on the effect of HIV and antiretroviral therapy on TB treatment outcomes among these highly infectious patients demonstrated conflicting results, reducing understanding of important issues. Methods: All adult smear-positive pulmonary TB patients diagnosed between 2008 and 2010 in Malawi’s largest public, integrated TB/HIV clinic were included in the study to assess treatment outcomes by HIV and antiretroviral therapy status using logistic regression. Results: Of 2,361 new smear-positive pulmonary TB patients, 86% had successful treatment outcome (were cured or completed treatment), 5% died, 6% were lost to follow-up, 1% failed treatment, and 2% transferred-out. Overall HIV prevalence was 56%. After adjusting for gender, age and TB registration year, treatment success was higher among HIV-negative than HIV-positive patients (adjusted odds ratio 1.49; 95% CI: 1.14–1.94). Of 1,275 HIV-infected pulmonary TB patients, 492 (38%) received antiretroviral therapy during the study. Pulmonary TB patients on antiretroviral therapy were more likely to have successful treatment outcomes than those not on ART (adjusted odds ratio : 1.83; 95% CI: 1.29–2.60). Conclusion: HIV co-infection was associated with poor TB treatment outcomes. Despite high HIV prevalence and the integrated TB/HIV setting, only a minority of patients started antiretroviral therapy. Intensified patient education and provider training on the benefits of antiretroviral therapy could increase antiretroviral therapy uptake and improve TB treatment success among these most infectious patients.
ACCESSION #
87624426

 

Related Articles

  • HIV-1 Infection Is Associated With an Earlier Occurrence of a Phenotype Related to Frailty. Desquilbet, Loic; Jacobson, Lisa P.; Fried, Linda P.; Phair, John P.; Jamieson, Beth D.; Holloway, Marcy; Margolick, Joseph B. // Journals of Gerontology Series A: Biological Sciences & Medical ;Nov2007, Vol. 62 Issue 11, p1279 

    Background. Older healthy and HIV-infected adults exhibit physiological similarities. Frailty is a clinical syndrome associated with aging that identifies a subset of older adults at high risk of mortality and other outcomes. We investigated whether HIV infection increases the prevalence of a...

  • Current Integration of Tuberculosis (TB) and HIV Services in South Africa, 2011. Chehab, Joel C.; Vilakazi-Nhlapo, Amanda K.; Vranken, Peter; Peters, Annatjie; Klausner, Jeffrey D. // PLoS ONE;Mar2013, Vol. 8 Issue 3, p1 

    Setting: Public Health Facilities in South Africa. Objective: To assess the current integration of TB and HIV services in South Africa, 2011. Design: Cross-sectional study of 49 randomly selected health facilities in South Africa. Trained interviewers administered a standardized...

  • ART during TB treatment saves lives at acceptable costs in SA.  // PharmacoEconomics & Outcomes News;Aug2015, Vol. 733 Issue 1, p8 

    The article reports on a study, published in the "Journal of Acquired Immune Deficiency Syndromes," which found that antiretroviral therapy (ART) during tuberculosis treatment in HIV-TB co-infected patients in South Africa is cost-effective and saves lives.

  • The HIV Care Continuum: Changes over Time in Retention in Care and Viral Suppression. Yehia, Baligh R.; Stephens-Shields, Alisa J.; Fleishman, John A.; Berry, Stephen A.; Agwu, Allison L.; Metlay, Joshua P.; Moore, Richard D.; Christopher Mathews, W.; Nijhawan, Ank; Rutstein, Richard; Gaur, Aditya H.; Gebo, Kelly A.; null, null // PLoS ONE;Jun2015, Vol. 10 Issue 6, p1 

    Background: The HIV care continuum (diagnosis, linkage to care, retention in care, receipt of antiretroviral therapy (ART), viral suppression) has been used to identify opportunities for improving the delivery of HIV care. Continuum steps are typically calculated in a conditional manner, with...

  • Nonadherence to Antiretroviral Therapy Among People Living with HIV/AIDS Attending Two Tertiary Care Hospitals in District of Northern India. Shukla, Mukesh; Agarwal, Monika; Singh, Jai Vir; Tripathi, Anil Kumar; Srivastava, Anand Kumar; Singh, Vijay Kumar // Indian Journal of Community Medicine;Jan-Mar2016, Vol. 41 Issue 1, p55 

    Introduction: Adherence to antiretroviral therapy is a principal predictor for the success of human immunodeficiency virus (HIV) treatment. It remains as a challenge to acquired immunodeficiency syndrome (AIDS) treatment and care with the widespread of the associated risks. Therefore, study aims...

  • Adherence to antiretroviral therapy (ART) during the early months of treatment in rural Zambia: influence of demographic characteristics and social surroundings of patients. Sasaki, Yuri; Kakimoto, Kazuhiro; Dube, Christopher; Sikazwe, Izukanji; Moyo, Crispin; Syakantu, Gardner; Komada, Kenichi; Miyano, Shinsuke; Ishikawa, Naoko; Kita, Kiyoshi; Kai, Ichiro // Annals of Clinical Microbiology & Antimicrobials;2012, Vol. 11 Issue 1, p1 

    Background: Around 70% of those living with HIV in need of treatment accessed antiretroviral therapy (ART) in Zambia by 2009. However, sustaining high levels of adherence to ART is a challenge. This study aimed to identify the predictive factors associated with ART adherence during the early...

  • Immuno-virologic outcomes and immunovirologic discordance among adults alive and on anti-retroviral therapy at 12 months in Nigeria. Anude, Chuka J.; Eze, Emeka; Onyegbutulem, Henry C.; Charurat, Man; Etiebet, Mary-Ann; Ajayi, Samuel; Dakum, Patrick; Akinwande, Oluyemisi; Beyrer, Chris; Abimiku, Alash'le; Blattner, William // BMC Infectious Diseases;2013, Vol. 13 Issue 1, p1 

    Background: Predictors of immuno-virologic outcomes and discordance and their associations with clinical, demographic, socio-economic and behavioral risk factors are not well described in Nigeria since HIV viral load testing is not routinely offered in public HIV treatment programs. Methods: The...

  • Response to antiretroviral therapy (ART): comparing women with previous use of zidovudine monotherapy (ZDVm) in pregnancy with ART naïve women. Huntington, Susie; Thorne, Claire; Anderson, Jane; Newell, Marie-Louise; Taylor, Graham P.; Pillay, Deenan; Hill, Teresa; Tookey, Pat; Sabin, Caroline // BMC Infectious Diseases;2014, Vol. 14 Issue 1, p1 

    Background Short-term zidovudine monotherapy (ZDVm) remains an option for some pregnant HIVpositive women not requiring treatment for their own health but may affect treatment responses once antiretroviral therapy (ART) is subsequently started. Methods Data were obtained by linking two UK...

  • Do accurate HIV and antiretroviral therapy knowledge, and previous testing experiences increase the uptake of HIV voluntary counselling and testing? Results from a cohort study in rural Tanzania. South, Annabelle; Wringe, Alison; Kumogola, Yusufu; Isingo, Raphael; Manyalla, Rose; Cawley, Caoimhe; Zaba, Basia; Todd, Jim; Urassa, Mark // BMC Public Health;2013, Vol. 13 Issue 1, p1 

    Background: Despite the introduction of free antiretroviral therapy (ART), the use of voluntary counselling and testing (VCT) services remains persistently low in many African countries. This study investigates how prior experience of HIV and VCT, and knowledge about HIV and ART influence VCT...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics