Comparison of effects of isoniazid plus ART and ART only regimen on the incidence of tuberculosis and HIV progression in HIV positive patients: a retrospective cohort study at two hospitals in Addis Ababa, Ethiopia

Edessa, Dumessa; Woldeyes, Tolera; Shibeshi, Workineh

doi:10.5455/2319-2003.ijbcp20140203

Cited by 2 publications

(3 citation statements)

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“…All the studies included were cohort studies and were published from 2012 to 2017. Among the 10 studies subjected to the meta-analysis, 2 articles [11,23] reported incident TB on pre-ART, 6 studies on ART [24][25][26][27][28][29] and 2 studies [12,30] in both pre-ART and ART receiving HIV positive patients. On the other hand, 2 articles [11,23] reported incident TB among pre-ART HIV infected patients within 6 months of follow up, whereas 2 studies [12,30] didn't indicate the follow up time clearly.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…On the other hand, 2 articles [11,23] reported incident TB among pre-ART HIV infected patients within 6 months of follow up, whereas 2 studies [12,30] didn't indicate the follow up time clearly. In the meantime, 2 articles [24,25] and 4 studies [26][27][28][29] reported incident TB within 6 and above 6 months of ART follow up respectively. Of the 10 studies, 7 articles [11,12,[23][24][25][26]29] reported incident TB regardless of the baseline CD4 + T cell count while 3 studies [27,28,30] stated incident TB data on ART in both baseline CD4 + T cell count < 200 and > 200 cells/mm 3 .…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…In the meantime, 2 articles [24,25] and 4 studies [26][27][28][29] reported incident TB within 6 and above 6 months of ART follow up respectively. Of the 10 studies, 7 articles [11,12,[23][24][25][26]29] reported incident TB regardless of the baseline CD4 + T cell count while 3 studies [27,28,30] stated incident TB data on ART in both baseline CD4 + T cell count < 200 and > 200 cells/mm 3 .…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Tuberculosis and its association with CD4+ T cell count among adult HIV positive patients in Ethiopian settings: a systematic review and meta-analysis

et al. 2020

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Background Tuberculosis (TB) and HV have been intertwined and makeup a deadly human syndemic worldwide, especially in developing countries like Ethiopia. Previous studies have reported different TB incidences and its association with CD4+ T cell counts among HIV positive patients in Ethiopia. Thus, the goal of this meta-analysis was, first, to determine pooled incident TB among adult HIV positive patients, and second, to assess the association between incident TB and baseline CD4+ T cell count strata’s. Methods We searched PubMed, Cochrane library, Science Direct and Google scholar databases from June 1 to 30, 2018. The I2 statistics and Egger’s regression test was used to determine heterogeneity and publication bias among included studies respectively. A random effects model was used to estimate pooled incident TB and odds ratio with the respective 95% confidence intervals using Stata version 11.0 statistical software. Results A total of 403 research articles were identified, and 10 studies were included in the meta-analysis. The pooled incident TB among adult HIV infected patients in Ethiopia was 16.58% (95% CI; 13.25–19.91%). Specifically, TB incidence in Pre-ART and ART was 17.16% (95% CI; 7.95–26.37%) and 16.24% (95% CI; 12.63–19.84%) respectively. Moreover, incident TB among ART receiving patients with baseline CD4+ T cell count < and > 200 cells/mm3 was 28.86% (95% CI; 18.73–38.98%) and 13.7% (95% CI; 1.41–25.98%) correspondingly. The odds of getting incident TB was 2.88 (95% CI; 1.55–5.35%) for patients with baseline CD4+ T cell count < 200 cells/mm3 compared to patients with baseline CD4+ T cell count > 200 cells/mm3. Conclusion High incident TB among adult HIV positive patients was estimated, especially in patients with CD4+ T cell count < 200 cells/mm3. Therefore, Early HIV screening and ART initiation, as well as strict compliance with ART and increasing the coverage of TB preventive therapy to more risky groups are important to prevent the problem. Trial registration Study protocol registration: CRD42018090802.

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Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Tuberculosis and its association with CD4+ T cell count among adult HIV positive patients in Ethiopian settings: a systematic review and meta-analysis

et al. 2020

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The protective effect of isoniazid preventive therapy on tuberculosis incidence among HIV positive patients receiving ART in Ethiopian settings: a meta-analysis

et al. 2019

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Background Tuberculosis (TB) and HIV makeup a deadly synergy of infectious disease, and the combined effect is apparent in resource limited countries like Ethiopia. Previous studies have demonstrated inconsistent results about the protective effect of isoniazid preventive therapy (IPT) on active TB incidence among HIV positive patients receiving ART. Therefore, the aim of this meta-analysis was, first, to determine the protective effect of IPT on active tuberculosis incidence, and second, to assess the pooled incidence of active TB among HIV positive patients taking ART with and without IPT intervention in Ethiopia. Methods PubMed, Google scholar and Cochran library databases were searched from April 1 to 30, 2018. Two independent authors explored and assessed studies for eligibility, and extracted data based on predefined criteria. Studies that reported TB incidence among HIV positive patients taking ART in Ethiopia with and without IPT concomitant intervention, and with a clear stratified data on the incidence of TB based on the duration of IPT intervention were selected. A random effects model was used to estimate risk ratios and the pooled incident TB with the respective 95% confidence intervals. Results We identified 7 suitable studies in this analysis. Accordingly, IPT reduced the risk of TB incidence by 74%, risk ratio (RR) 0.26 (95% CI; 0.16–0.43%), compared to no IPT group. Moreover, IPT for 12 months reduced incident TB by 91% (RR: 0.09, 95% CI: 0.04 to 0.21), whereas 6 months IPT averted TB incidence by 63% (RR: 0.37, 95% CI: 0.26 to 0.52). The overall pooled incident TB among HIV infected patients receiving ART was 10.30% (95% CI; 7.57–13.02%). Specifically, incident TB among study cohorts with and without IPT was 3.79% (95% CI; 2.03–5.55%) and 16.32% (95% CI; 11.57–21.06%) respectively. Conclusion IPT reduced the risk of incident TB among HIV positive patients receiving ART in Ethiopian settings. Moreover, the duration of IPT intervention has effect on its protective role. Thus, scaling up the isoniazid preventive therapy program and its strict compliance is necessary to avert HIV fueled tuberculosis. Study protocol registration CRD42018090804. Electronic supplementary material The online version of this article (10.1186/s12879-019-4031-2) contains supplementary material, which is available to authorized users.

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Comparison of effects of isoniazid plus ART and ART only regimen on the incidence of tuberculosis and HIV progression in HIV positive patients: a retrospective cohort study at two hospitals in Addis Ababa, Ethiopia

Cited by 2 publications

References 27 publications

Tuberculosis and its association with CD4+ T cell count among adult HIV positive patients in Ethiopian settings: a systematic review and meta-analysis

Tuberculosis and its association with CD4+ T cell count among adult HIV positive patients in Ethiopian settings: a systematic review and meta-analysis

The protective effect of isoniazid preventive therapy on tuberculosis incidence among HIV positive patients receiving ART in Ethiopian settings: a meta-analysis

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