Navigation Links
Combined drug therapy to treat TB and HIV significantly improves survival
Date:2/25/2010

Initiating antiretroviral therapy (ART) during tuberculosis therapy significantly reduced mortality rates by 56 percent in a randomized clinical trial of 642 patients co-infected with HIV and tuberculosis. The study, which provides further impetus for the integration of TB and HIV services, lays to rest the controversy on whether co-infected patients should initiate ART during or after TB treatment. Findings are published in the February 25th issue of The New England Journal of Medicine.

Tuberculosis is the most common opportunistic disease and the most frequent cause of death in patients with HIV infection in developing countries, and the number of patients with co-infection continues to grow rapidly.

"Despite World Health Organization(WHO) guidelines supporting concomitant treatment of the two diseases and urging more aggressive management initiation of antiretroviral therapy, treatment often has been deferred until completion of tuberculosis therapy because of concern about potential drug interactions, overlapping side effects, a high pill burden, and programmatic challenges," said Salim S. Abdool Karim, MD, PhD, professor of clinical epidemiology at Columbia University's Mailman School of Public Health, pro vice-chancellor (research) at the University of KwaZulu-Natal in Durban, South Africa, and principal investigator of the study.

The new study, called the Starting Antiretroviral Therapy at Three Points in Tuberculosis (SAPiT), was designed to determine the optimal time to initiate antiretroviral therapy in patients with HIV and tuberculosis co-infection who were receiving tuberculosis therapy. The trial was conducted at the eThekwini HIVtuberculosis clinic, operated by the Centre for the AIDS Programme of Research in South Africa (CAPRISA) in Durban, South Africa.

Of the 642 patients in the trial, 429 were in the combined integrated-therapy groups who initiated ART during TB treatment as compared with the 213 patients in the sequential-therapy group who initiated ART only after TB treatment was completed. Only patients with TB and HIV infection with a CD4+ cell count of less than 500 cells per cubic millimeter were included in the study.

All patients received standard tuberculosis therapy and a once-daily antiretroviral regimen.

Based on the results of this study, the World Health Organization guidelines for treatment of TB and HIV co-infection were revised in late 2009. On World AIDS Day in 2009, President Zuma of South Africa announced the new policy, to provide ART to all TB patients with HIV infection and CD4 counts below 350 cells per cubic millimeter.

"Our findings provide compelling evidence of the benefit of initiating antiretroviral therapy during tuberculosis therapy in patients with HIV co-infection, and also support recommendations by the WHO and others for the integration of tuberculosis and HIV care," notes Dr. Karim.


'/>"/>

Contact: Stephanie Berger
sb2247@columbia.edu
212-305-4372
Columbia University's Mailman School of Public Health
Source:Eurekalert

Related medicine news :

1. Combined mammography and breast MRI useful for some high-risk women
2. Green tea chemical combined with another may hold promise for treatment of brain disorders
3. Holistic and Western Medicine Combined Can Fight Cancer
4. UnitedHealthcare To Offer Seniors Hispanic-Centered Medicare Education Seminars Combined With a Latin-Themed Fitness Program
5. Report Finds Alzheimer's Killing More People Than Breast And Prostate Cancer Combined
6. Research: People With Type 2 Diabetes Improved Muscular Strength and Exercise Capacity Through Physical Therapist Exercise Counseling Combined With Fitness Center Exercise Training
7. Study finds promise in combined transplant/vaccine therapy for high-risk leukemia
8. FDA Approves LIVALO(R) for Primary Hypercholesterolemia and Combined Dyslipidemia
9. Recently Released Data from the National Survey of Childrens Health Reports That Autism Now Affects 1% of Children and is More Common Than Childrens Cancer, Diabetes, and AIDS Combined.
10. Hard To Treat Diseases (HTDS) Clinical Trial Update on Therapeutic effects of Combined Treatment With Ribavirin And Tiazofurin
11. Childrens Hospital of Philadelphia Earns Highest Combined US News Score in 10 Specialties Ranked by U.S. News & World Report
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... , ... Apple Rehab Shelton Lakes , which specializes in the delivery ... as part of a disaster drill on October 3rd. , Apple Rehab participated with ... Manager, as well as the Connecticut Long Term Care Mutual Aid Plan (LTC-MAP). ...
(Date:10/13/2017)... Texas (PRWEB) , ... October 13, 2017 , ... Yisrayl ... this week that explains one of the most popular and least understood books in ... like cryptic and puzzling descriptions that have baffled scholars for centuries. Many have tossed ...
(Date:10/12/2017)... ... October 12, 2017 , ... First Healthcare Compliance (FHC), ... will showcase a range of technology and learning solutions at the 68th Annual ... Expo to be held October 14–18, 2017 at the Mandalay Bay Resort in ...
(Date:10/12/2017)... ... October 12, 2017 , ... The American College of Medical ... Friedman, PhD, FACMI, during the Opening Session of AMIA’s Annual Symposium in Washington, D.C. ... honor of Morris F. Collen, a pioneer in the field of medical informatics, this ...
(Date:10/12/2017)... ... , ... Leading pediatric oncology experts at Children’s National Health System ... of the International Society of Paediatric Oncology (SIOP) Oct. 12-15. Chaired by ... Blood Disorders at Children’s National, and Stephen P. Hunger, M.D., Chief of the ...
Breaking Medicine News(10 mins):
(Date:10/4/2017)... Oct. 4, 2017  South Korean-based healthcare product Development ... aide "cprCUBE" on Kickstarter. The device will educate the ... arrests with better efficiency compared to the dated and ... feedback on efficacy of the compression for a more ... a goal to raise $5,000. ...
(Date:10/2/2017)... 2, 2017  AllianceRx Walgreens Prime, the combined central ... and pharmacy benefit manager Prime Therapeutics LLC (Prime), today ... included the unveiling of new signage at its headquarters ... as at a few other company-owned facilities across the ... patients, some of whom will begin to see the ...
(Date:9/27/2017)...  Commended for their devotion to personalized service, SMP Pharmacy ... one in the South Florida Business Journal,s 50 Fastest-Growing Companies, ... list, the national specialty pharmacy has found its niche.  To ... soon be honored by SFBJ as the 2017 Power Leader ... to receive his award in October, Bardisa said of the ...
Breaking Medicine Technology: