Antiretroviral Therapy for HIV-Infected Tuberculosis Patients Saves Lives but Needs to Be Used More Frequently in Thailand
INTRODUCTION:The impact of antiretroviral therapy (ART) on HIV-infected tuberculosis (TB) patients in public health programs in resource-limited settings is not well documented due to problems with statistical bias in observational studies. METHODS:We measured the impact of ART on survival of HIV-in...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2008-06, Vol.48 (2), p.181-189 |
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| container_title | Journal of acquired immune deficiency syndromes (1999) |
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| creator | Sanguanwongse, Natpatou Cain, Kevin P Suriya, Patcharin Nateniyom, Sriprapa Yamada, Norio Wattanaamornkiat, Wanpen Sumnapan, Surin Sattayawuthipong, Wanchai Kaewsa-ard, Samroui Ingkaseth, Sakon Varma, Jay K |
| description | INTRODUCTION:The impact of antiretroviral therapy (ART) on HIV-infected tuberculosis (TB) patients in public health programs in resource-limited settings is not well documented due to problems with statistical bias in observational studies.
METHODS:We measured the impact of ART on survival of HIV-infected TB patients in Thailand using a propensity score analysis that adjusted for factors associated with receiving ART.
RESULTS:Of 626 HIV-infected TB patients started on ART during TB treatment, 68 (11%) died compared with 295/643 (46%) of patients not prescribed ART (relative risk 0.24, 95% confidence interval0.19 to 0.30); in patients with very low CD4 ( |
| doi_str_mv | 10.1097/QAI.0b013e318177594e |
| format | Article |
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METHODS:We measured the impact of ART on survival of HIV-infected TB patients in Thailand using a propensity score analysis that adjusted for factors associated with receiving ART.
RESULTS:Of 626 HIV-infected TB patients started on ART during TB treatment, 68 (11%) died compared with 295/643 (46%) of patients not prescribed ART (relative risk 0.24, 95% confidence interval0.19 to 0.30); in patients with very low CD4 (<10), 12/56 (21%) patients receiving ART died compared with 35/43 (81%) patients not receiving ART (relative risk 0.26, 95% confidence interval0.16 to 0.44). Patients treated in the private sector and in rural areas were less commonly prescribed ART. After controlling for propensity to receive ART, the hazard ratio for death among patients treated with ART was 0.17 (95% confidence interval0.12 to 0.24).
DISCUSSION:Patients who received ART had one sixth the risk of death of those not receiving ART. The survival benefit persisted even for those with a very low CD4 count. Expanding use of ART in HIV-infected TB patients will require increasing ART use in the private sector and rural areas.</description><identifier>ISSN: 1525-4135</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0b013e318177594e</identifier><identifier>PMID: 18520676</identifier><identifier>CODEN: JDSRET</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Adolescent ; Adult ; Aged ; AIDS/HIV ; Anti-HIV Agents - therapeutic use ; Antiretroviral drugs ; Asian people ; Bacterial diseases ; Biological and medical sciences ; CD4 Lymphocyte Count ; Child ; Child, Preschool ; Drug therapy ; Female ; Fundamental and applied biological sciences. Psychology ; HIV ; HIV Infections - complications ; HIV Infections - drug therapy ; HIV Infections - immunology ; Human bacterial diseases ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Infant ; Infectious diseases ; Male ; Medical sciences ; Microbiology ; Middle Aged ; Miscellaneous ; Mycobacterium ; Public health ; Thailand ; Tuberculosis ; Tuberculosis - mortality ; Tuberculosis and atypical mycobacterial infections ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Virology</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2008-06, Vol.48 (2), p.181-189</ispartof><rights>2008 Lippincott Williams & Wilkins, Inc.</rights><rights>2008 INIST-CNRS</rights><rights>Copyright Lippincott Williams & Wilkins Jun 1, 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5150-6526a96a3c6738dcdebb4765b2677063e755ff16641afa267428423e7d84bc6c3</citedby><cites>FETCH-LOGICAL-c5150-6526a96a3c6738dcdebb4765b2677063e755ff16641afa267428423e7d84bc6c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttp://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=n&CSC=Y&PAGE=fulltext&D=ovft&AN=00126334-200806010-00010$$EHTML$$P50$$Gwolterskluwer$$H</linktohtml><link.rule.ids>314,776,780,4595,27901,27902,65206</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20393421$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18520676$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sanguanwongse, Natpatou</creatorcontrib><creatorcontrib>Cain, Kevin P</creatorcontrib><creatorcontrib>Suriya, Patcharin</creatorcontrib><creatorcontrib>Nateniyom, Sriprapa</creatorcontrib><creatorcontrib>Yamada, Norio</creatorcontrib><creatorcontrib>Wattanaamornkiat, Wanpen</creatorcontrib><creatorcontrib>Sumnapan, Surin</creatorcontrib><creatorcontrib>Sattayawuthipong, Wanchai</creatorcontrib><creatorcontrib>Kaewsa-ard, Samroui</creatorcontrib><creatorcontrib>Ingkaseth, Sakon</creatorcontrib><creatorcontrib>Varma, Jay K</creatorcontrib><title>Antiretroviral Therapy for HIV-Infected Tuberculosis Patients Saves Lives but Needs to Be Used More Frequently in Thailand</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>INTRODUCTION:The impact of antiretroviral therapy (ART) on HIV-infected tuberculosis (TB) patients in public health programs in resource-limited settings is not well documented due to problems with statistical bias in observational studies.
METHODS:We measured the impact of ART on survival of HIV-infected TB patients in Thailand using a propensity score analysis that adjusted for factors associated with receiving ART.
RESULTS:Of 626 HIV-infected TB patients started on ART during TB treatment, 68 (11%) died compared with 295/643 (46%) of patients not prescribed ART (relative risk 0.24, 95% confidence interval0.19 to 0.30); in patients with very low CD4 (<10), 12/56 (21%) patients receiving ART died compared with 35/43 (81%) patients not receiving ART (relative risk 0.26, 95% confidence interval0.16 to 0.44). Patients treated in the private sector and in rural areas were less commonly prescribed ART. After controlling for propensity to receive ART, the hazard ratio for death among patients treated with ART was 0.17 (95% confidence interval0.12 to 0.24).
DISCUSSION:Patients who received ART had one sixth the risk of death of those not receiving ART. The survival benefit persisted even for those with a very low CD4 count. Expanding use of ART in HIV-infected TB patients will require increasing ART use in the private sector and rural areas.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>AIDS/HIV</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral drugs</subject><subject>Asian people</subject><subject>Bacterial diseases</subject><subject>Biological and medical sciences</subject><subject>CD4 Lymphocyte Count</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>HIV</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - immunology</subject><subject>Human bacterial diseases</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infant</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Microbiology</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Mycobacterium</subject><subject>Public health</subject><subject>Thailand</subject><subject>Tuberculosis</subject><subject>Tuberculosis - mortality</subject><subject>Tuberculosis and atypical mycobacterial infections</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><subject>Virology</subject><issn>1525-4135</issn><issn>1944-7884</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkl1rFDEUhgdRbK3-A5Eg6N3UfJ5MLmuxdmH9wq23QyZzhk2dnaxJpmX99WbpYqE3epOEl-ec9xzeVNVLRk8ZNfrdt7PFKe0oEyhYw7RWRuKj6pgZKWvdNPJxeSuuasmEOqqepXRNKQMpzdPqiDWKU9BwXP0-m7KPmGO48dGOZLXGaLc7MoRILhc_6sU0oMvYk9XcYXTzGJJP5KvNHqecyHd7g4ks_f7s5kw-I_aJ5EDeI7lKpexTiEguIv6aCz_uiJ-KhfWjnfrn1ZPBjglfHO6T6uriw-r8sl5--bg4P1vWTjFFa1AcrAErHGjR9K7HrpMaVMdBawoCtVLDwAAks4MtouSN5EXuG9k5cOKkenvXdxtDGSPlduOTw7HMgGFOrWbAjdHinyAzxQpA_Q8owYimgK8fgNdhjlPZtuVCgDIG9pC8g1wMKUUc2m30Gxt3LaPtPuq2RN0-jLqUvTr0nrsN9vdFh2wL8OYA2OTsOEQ7OZ_-cpwKIyRn9_63YcwY089xvsXYrtGOed2WT8NBCFlzShsKlNGaFo2KP6B8wI8</recordid><startdate>20080601</startdate><enddate>20080601</enddate><creator>Sanguanwongse, Natpatou</creator><creator>Cain, Kevin P</creator><creator>Suriya, Patcharin</creator><creator>Nateniyom, Sriprapa</creator><creator>Yamada, Norio</creator><creator>Wattanaamornkiat, Wanpen</creator><creator>Sumnapan, Surin</creator><creator>Sattayawuthipong, Wanchai</creator><creator>Kaewsa-ard, Samroui</creator><creator>Ingkaseth, Sakon</creator><creator>Varma, Jay K</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7T5</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7QL</scope><scope>7U1</scope><scope>7U2</scope><scope>7X8</scope></search><sort><creationdate>20080601</creationdate><title>Antiretroviral Therapy for HIV-Infected Tuberculosis Patients Saves Lives but Needs to Be Used More Frequently in Thailand</title><author>Sanguanwongse, Natpatou ; Cain, Kevin P ; Suriya, Patcharin ; Nateniyom, Sriprapa ; Yamada, Norio ; Wattanaamornkiat, Wanpen ; Sumnapan, Surin ; Sattayawuthipong, Wanchai ; Kaewsa-ard, Samroui ; Ingkaseth, Sakon ; Varma, Jay K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5150-6526a96a3c6738dcdebb4765b2677063e755ff16641afa267428423e7d84bc6c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>AIDS/HIV</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antiretroviral drugs</topic><topic>Asian people</topic><topic>Bacterial diseases</topic><topic>Biological and medical sciences</topic><topic>CD4 Lymphocyte Count</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>HIV</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - immunology</topic><topic>Human bacterial diseases</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infant</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Microbiology</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Mycobacterium</topic><topic>Public health</topic><topic>Thailand</topic><topic>Tuberculosis</topic><topic>Tuberculosis - mortality</topic><topic>Tuberculosis and atypical mycobacterial infections</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><topic>Virology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sanguanwongse, Natpatou</creatorcontrib><creatorcontrib>Cain, Kevin P</creatorcontrib><creatorcontrib>Suriya, Patcharin</creatorcontrib><creatorcontrib>Nateniyom, Sriprapa</creatorcontrib><creatorcontrib>Yamada, Norio</creatorcontrib><creatorcontrib>Wattanaamornkiat, Wanpen</creatorcontrib><creatorcontrib>Sumnapan, Surin</creatorcontrib><creatorcontrib>Sattayawuthipong, Wanchai</creatorcontrib><creatorcontrib>Kaewsa-ard, Samroui</creatorcontrib><creatorcontrib>Ingkaseth, Sakon</creatorcontrib><creatorcontrib>Varma, Jay K</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sanguanwongse, Natpatou</au><au>Cain, Kevin P</au><au>Suriya, Patcharin</au><au>Nateniyom, Sriprapa</au><au>Yamada, Norio</au><au>Wattanaamornkiat, Wanpen</au><au>Sumnapan, Surin</au><au>Sattayawuthipong, Wanchai</au><au>Kaewsa-ard, Samroui</au><au>Ingkaseth, Sakon</au><au>Varma, Jay K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antiretroviral Therapy for HIV-Infected Tuberculosis Patients Saves Lives but Needs to Be Used More Frequently in Thailand</atitle><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle><addtitle>J Acquir Immune Defic Syndr</addtitle><date>2008-06-01</date><risdate>2008</risdate><volume>48</volume><issue>2</issue><spage>181</spage><epage>189</epage><pages>181-189</pages><issn>1525-4135</issn><eissn>1944-7884</eissn><coden>JDSRET</coden><abstract>INTRODUCTION:The impact of antiretroviral therapy (ART) on HIV-infected tuberculosis (TB) patients in public health programs in resource-limited settings is not well documented due to problems with statistical bias in observational studies.
METHODS:We measured the impact of ART on survival of HIV-infected TB patients in Thailand using a propensity score analysis that adjusted for factors associated with receiving ART.
RESULTS:Of 626 HIV-infected TB patients started on ART during TB treatment, 68 (11%) died compared with 295/643 (46%) of patients not prescribed ART (relative risk 0.24, 95% confidence interval0.19 to 0.30); in patients with very low CD4 (<10), 12/56 (21%) patients receiving ART died compared with 35/43 (81%) patients not receiving ART (relative risk 0.26, 95% confidence interval0.16 to 0.44). Patients treated in the private sector and in rural areas were less commonly prescribed ART. After controlling for propensity to receive ART, the hazard ratio for death among patients treated with ART was 0.17 (95% confidence interval0.12 to 0.24).
DISCUSSION:Patients who received ART had one sixth the risk of death of those not receiving ART. The survival benefit persisted even for those with a very low CD4 count. Expanding use of ART in HIV-infected TB patients will require increasing ART use in the private sector and rural areas.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>18520676</pmid><doi>10.1097/QAI.0b013e318177594e</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged AIDS/HIV Anti-HIV Agents - therapeutic use Antiretroviral drugs Asian people Bacterial diseases Biological and medical sciences CD4 Lymphocyte Count Child Child, Preschool Drug therapy Female Fundamental and applied biological sciences. Psychology HIV HIV Infections - complications HIV Infections - drug therapy HIV Infections - immunology Human bacterial diseases Human immunodeficiency virus Human viral diseases Humans Infant Infectious diseases Male Medical sciences Microbiology Middle Aged Miscellaneous Mycobacterium Public health Thailand Tuberculosis Tuberculosis - mortality Tuberculosis and atypical mycobacterial infections Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Virology |
| title | Antiretroviral Therapy for HIV-Infected Tuberculosis Patients Saves Lives but Needs to Be Used More Frequently in Thailand |
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