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    Feb 24, 2021
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    Does Antiretroviral Treatment Reduce Case Fatality Among HIV-Positive Patients with Tuberculosis in Malawi?

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    Authors
    Zachariah, R
    Fitzgerald, M
    Massaquoi, M
    Acabu, A
    Chilomo, D
    Salaniponi, F M L
    Harries, A D
    Affiliation
    Medical Department (Operational Research), Médecins sans Frontières, Brussels Operational Centre, Luxembourg. zachariah@internet.lu
    Issue Date
    2007-08
    
    Metadata
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    Journal
    International Journal of Tuberculosis and Lung Disease
    Abstract
    SETTING: Thyolo district, Malawi. OBJECTIVES: To report on 1) case fatality among human immunodeficiency virus (HIV) positive tuberculosis (TB) patients while on anti-tuberculosis treatment and 2) whether antiretroviral treatment (ART) initiated during the continuation phase of TB treatment reduces case fatality. DESIGN: Retrospective cohort analysis. METHODS: Comparative analysis of treatment outcomes for TB patients registered between January and December 2004. RESULTS: Of 983 newly registered TB patients receiving diagnostic HIV testing, 658 (67%) were HIV-positive. A total of 132 (20%) patients died during the 8-month course of anti-tuberculosis treatment, of whom 82 (62%) died within the first 2 months of treatment when ART was not provided (cumulative incidence 3.0, 95%CI 2.5-3.6 per 100 person-years). A total of 576 TB patients started the continuation phase of anti-tuberculosis treatment, 180 (31%) of whom were started on ART. The case-fatality rate per 100 person-years was not significantly different for patients on ART (1.0, 95%CI 0.6-1.7) and those without ART (1.2, 95%CI 0.9-1.7, adjusted hazard ratio 0.86, 95%CI 0.4-1.6, P = 0.6) CONCLUSIONS: ART provided in the continuation phase of TB treatment does not have a significant impact on reducing case fatality. Reasons for this and possible measures to reduce high case fatality in the initial phase of TB treatment are discussed.
    URI
    http://hdl.handle.net/10144/19396
    PubMed ID
    17705949
    Additional Links
    http://www.ingentaconnect.com/content/iuatld/ijtld
    Language
    en
    ISSN
    1027-3719
    Collections
    TB

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