Prognostic significance of the interval between the initiation of antiretroviral therapy and the initiation of anti‐tuberculosis treatment in <scp>HIV</scp>/tuberculosis‐coinfected patients: results from the <scp>TREAT A</scp>sia <scp>HIV O</scp>bservational <scp>D</scp>atabase

Han, Shufen; Zhou, Jialun; Lee, MP; Zhao, Hong; Chen, Y-MA; Kumarasamy, N.; Pujari, Sanjay; Lee, C; Omar, S.F. Syed; Ditangco, Rossana; Phanuphak, Nittaya; Kiertiburanakul, Sasisopin; Chaiwarith, Romanee; Merati, TP; Yunihastuti, Evy; Tanuma, Junko; Saphonn, Vonthanak; Sohn, AH; Choi, Jae Young

doi:10.1111/hiv.12073

Cited by 10 publications

(22 citation statements)

References 22 publications

(29 reference statements)

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“…The mortality rate in our study is considerably higher when compared to the mortality rates reported in previous studies from the same region, which ranged from 1.46/100pys to 3.77/100pys (1, 3). The large difference could be due to the short follow-up time, which is a limitation of our study.…”

Section: To the Editorcontrasting

confidence: 83%

“…To further expand on available data around TB co-infection and associated treatment outcomes in HIV-infected patients in Asia (1), we investigated survival outcomes in HIV-positive-TB co-infected patients.…”

Section: To the Editormentioning

confidence: 99%

“…

Tuberculosis (TB) is highly prevalent in the Asia-Pacific region, accounting for 61% of estimated cases globally in 2015. To further expand on available data around TB coinfection and associated treatment outcomes in HIVinfected patients in Asia [1], we investigated survival outcomes in HIV-positive TB-coinfected patients.HIV-positive TB-coinfected cases were selected from those who were recruited into TREAT Asia's study of socio-economic determinants of TB in HIV/TB-coinfected patients in Asia (see Appendix 1 for study members) [2]. Survival time from TB diagnosis was plotted using the Kaplan-Meier (K-M) curve and analysed using Cox regression.

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confidence: 99%

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Mortality following diagnosis of tuberculosis in HIV‐infected patients in Asia

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Section: To the Editorcontrasting

confidence: 83%

Section: To the Editormentioning

confidence: 99%

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Mortality following diagnosis of tuberculosis in HIV‐infected patients in Asia

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“…Three studies explicitly reported on how death was ascertained or confirmed (Table 2) [38], [39], [45].…”

Section: Resultsmentioning

confidence: 99%

The Impact of Antiretroviral Therapy on Mortality in HIV Positive People during Tuberculosis Treatment: A Systematic Review and Meta-Analysis

et al. 2014

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ObjectiveTo quantify the impact of antiretroviral therapy (ART) on mortality in HIV-positive people during tuberculosis (TB) treatment.DesignWe conducted a systematic literature review and meta-analysis. Studies published from 1996 through February 15, 2013, were identified by searching electronic resources (Pubmed and Embase) and conference books, manual searches of references, and expert consultation. Pooled estimates for the outcome of interest were acquired using random effects meta-analysis.SubjectsThe study population included individuals receiving ART before or during TB treatment.Main Outcome MeasuresMain outcome measures were: (i) TB-case fatality ratio (CFR), defined as the proportion of individuals dying during TB treatment and, if mortality in HIV-positive people not on ART was also reported, (ii) the relative risk of death during TB treatment by ART status.ResultsTwenty-one studies were included in the systematic review. Random effects pooled meta-analysis estimated the CFR between 8% and 14% (pooled estimate 11%). Among HIV-positive TB cases, those receiving ART had a reduction in mortality during TB treatment of between 44% and 71% (RR = 0.42, 95%CI: 0.29–0.56).ConclusionStarting ART before or during TB therapy reduces the risk of death during TB treatment by around three-fifths in clinical settings. National programmes should continue to expand coverage of ART for HIV positive in order to control the dual epidemic.

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“…A study investigating the risk of TB diagnosis after recruitment into the TREAT Asia HIV Observational Database (TAHOD) reported TB incidence of 1.98 per 100 person-years of follow-up with younger age, lower CD4 cell count, antiretroviral therapy (ART) duration, and living high TB burden countries being significantly associated with the diagnosis of TB (11). Additionally, it was found that delayed ART initiation after TB therapy did not affect mortality rates in TAHOD patients (12). …”

Section: Introductionmentioning

confidence: 99%

Socio-economic status and risk of tuberculosis: a case-control study of HIV-infected patients in Asia

Jiamsakul

Lee

Nguyen

et al. 2018

int j tuberc lung dis

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Setting Tuberculosis (TB) is the most common HIV-related opportunistic infection and AIDS-related death. TB often affects those from low socio-economic background. Objective This matched case-control study was designed to assess socio-economic determinants of TB in HIV-infected patients in Asia. Design HIV-positive-TB-positive cases were matched to HIV-positive-TB-negative controls according to age, sex and CD4 cell count. A socio-economic questionnaire consisting of 23 questions including education level, employment, housing and substance use, was distributed. Socio-economic risk factors for TB was analysed using conditional logistic regression analysis. Results A total of 340 patients (170 matched pairs) were recruited, with 262 (77.1%) matched on all three criteria. Pulmonary TB was the predominant type (115, 67.6%). The main risk factor for TB was not having university level education (OR=4.45, 95%CI (1.50-13.17), p=0.007). Burning wood or coal regularly inside the house and living in the same place of origin were weakly associated with TB diagnosis. Conclusions Our data suggests that lower socio-economic status is associated with increased risk of TB in Asia. Integrating clinical and socio-economic factors into the treatment of HIV may help in the prevention of opportunistic infections and disease progression.

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Prognostic significance of the interval between the initiation of antiretroviral therapy and the initiation of anti‐tuberculosis treatment in HIV/tuberculosis‐coinfected patients: results from the TREAT Asia HIV Observational Database

Cited by 10 publications

References 22 publications

Mortality following diagnosis of tuberculosis in HIV‐infected patients in Asia

Mortality following diagnosis of tuberculosis in HIV‐infected patients in Asia

The Impact of Antiretroviral Therapy on Mortality in HIV Positive People during Tuberculosis Treatment: A Systematic Review and Meta-Analysis

Socio-economic status and risk of tuberculosis: a case-control study of HIV-infected patients in Asia

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