dc.contributor.author |
Cortes, Claudia P. |
|
dc.contributor.author |
Wehbe, Firas H. |
|
dc.contributor.author |
McGowan, Catherine C. |
|
dc.contributor.author |
Shepherd, Bryan E. |
|
dc.contributor.author |
Duda, Stephany N. |
|
dc.contributor.author |
Jenkins, Cathy A. |
|
dc.contributor.author |
González Lagos, Elsa Violeta |
|
dc.contributor.author |
Carriquiry, Gabriela |
|
dc.contributor.author |
Schechter, Mauro |
|
dc.contributor.author |
Padgett, Denis |
|
dc.contributor.author |
Cesar, Carina |
|
dc.contributor.author |
Madero, Juan Sierra |
|
dc.contributor.author |
Pape, JeanW. |
|
dc.contributor.author |
Masys, D.R. |
|
dc.contributor.author |
Sterling, T.R. |
|
dc.contributor.author |
Wolff, M. |
|
dc.contributor.author |
Arancibia, J.M. |
|
dc.contributor.author |
Saavedra, F. |
|
dc.contributor.author |
Salinas, C. |
|
dc.contributor.author |
Gonzalez, E. |
|
dc.contributor.author |
Carriquiry, G. |
|
dc.contributor.author |
Mayer, E. |
|
dc.contributor.author |
Condorhuaman, P. |
|
dc.contributor.author |
Gotuzzo Herencia, José Eduardo |
|
dc.contributor.author |
Schechter, M. |
|
dc.contributor.author |
Tuboi, S.H. |
|
dc.contributor.author |
Padgett, D. |
|
dc.contributor.author |
Cesar, C. |
|
dc.contributor.author |
Fink, V. |
|
dc.contributor.author |
Sued, O. |
|
dc.contributor.author |
Cahn, P. |
|
dc.contributor.author |
Crabtree, B. |
|
dc.contributor.author |
Madero, J.S. |
|
dc.contributor.author |
Bacon, M. |
|
dc.contributor.author |
Williams, C. |
|
dc.contributor.author |
Shepherd, B.E. |
|
dc.contributor.author |
Jenkins, C.A. |
|
dc.contributor.author |
Duda, S.N. |
|
dc.contributor.author |
Masys, D.R. |
|
dc.contributor.author |
McGowan, C.C. |
|
dc.date.accessioned |
2022-01-04T20:31:48Z |
|
dc.date.available |
2022-01-04T20:31:48Z |
|
dc.date.issued |
2013 |
|
dc.identifier.uri |
https://hdl.handle.net/20.500.12866/10673 |
|
dc.description.abstract |
Background: Antiretroviral therapy (ART) decreases mortality risk in HIV-infected tuberculosis patients, but the effect of the duration of anti-tuberculosis therapy and timing of anti-tuberculosis therapy initiation in relation to ART initiation on mortality, is unclear. Methods: We conducted a retrospective observational multi-center cohort study among HIV-infected persons concomitantly treated with Rifamycin-based anti-tuberculosis therapy and ART in Latin America. The study population included persons for whom 6 months of anti-tuberculosis therapy is recommended. Results: Of 253 patients who met inclusion criteria, median CD4+ lymphocyte count at ART initiation was 64 cells/mm3, 171 (68%) received >180 days of anti-tuberculosis therapy, 168 (66%) initiated anti-tuberculosis therapy before ART, and 43 (17%) died. In a multivariate Cox proportional hazards model that adjusted for CD4+ lymphocytes and HIV-1 RNA, tuberculosis diagnosed after ART initiation was associated with an increased risk of death compared to tuberculosis diagnosis before ART initiation (HR 2.40; 95% CI 1.15, 5.02; P = 0.02). In a separate model among patients surviving >6 months after tuberculosis diagnosis, after adjusting for CD4+ lymphocytes, HIV-1 RNA, and timing of ART initiation relative to tuberculosis diagnosis, receipt of >6 months of anti-tuberculosis therapy was associated with a decreased risk of death (HR 0.23; 95% CI 0.08, 0.66; P=0.007). Conclusions: The increased risk of death among persons diagnosed with tuberculosis after ART initiation highlights the importance of screening for tuberculosis before ART initiation. The decreased risk of death among persons receiving > 6 months of anti-tuberculosis therapy suggests that current anti-tuberculosis treatment duration guidelines should be re-evaluated. |
en_US |
dc.language.iso |
eng |
|
dc.publisher |
Public Library of Science |
|
dc.relation.ispartofseries |
PLoS ONE |
|
dc.rights |
info:eu-repo/semantics/restrictedAccess |
|
dc.rights.uri |
https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es |
|
dc.subject |
Tuberculosis |
en_US |
dc.subject |
Humans |
en_US |
dc.subject |
major clinical study |
en_US |
dc.subject |
tuberculosis |
en_US |
dc.subject |
risk factor |
en_US |
dc.subject |
Anti-HIV Agents |
en_US |
dc.subject |
HIV Infections |
en_US |
dc.subject |
Human immunodeficiency virus infection |
en_US |
dc.subject |
Time Factors |
en_US |
dc.subject |
antiretrovirus agent |
en_US |
dc.subject |
cohort analysis |
en_US |
dc.subject |
CD4 lymphocyte count |
en_US |
dc.subject |
risk assessment |
en_US |
dc.subject |
Retrospective Studies |
en_US |
dc.subject |
retrospective study |
en_US |
dc.subject |
article |
en_US |
dc.subject |
Human immunodeficiency virus 1 |
en_US |
dc.subject |
risk reduction |
en_US |
dc.subject |
mortality |
en_US |
dc.subject |
observational study |
en_US |
dc.subject |
treatment duration |
en_US |
dc.subject |
virus RNA |
en_US |
dc.subject |
Human immunodeficiency virus proteinase inhibitor |
en_US |
dc.subject |
nonnucleoside reverse transcriptase inhibitor |
en_US |
dc.subject |
RNA directed DNA polymerase inhibitor |
en_US |
dc.subject |
efavirenz |
en_US |
dc.subject |
nevirapine |
en_US |
dc.subject |
rifamycin |
en_US |
dc.subject |
survival time |
en_US |
dc.title |
Duration of Anti-Tuberculosis Therapy and Timing of Antiretroviral Therapy Initiation: Association with Mortality in HIV-Related Tuberculosis |
en_US |
dc.type |
info:eu-repo/semantics/article |
|
dc.identifier.doi |
https://doi.org/10.1371/journal.pone.0074057 |
|
dc.subject.ocde |
https://purl.org/pe-repo/ocde/ford#3.03.08 |
|
dc.relation.issn |
1932-6203 |
|