Navigation Links
Combined drug therapy to treat TB and HIV significantly improves survival

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
Columbia University's Mailman School of Public Health

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:
(Date:10/13/2015)... ... 2015 , ... Tempe Dental Care, a leading Tempe dentists’ office, celebrates offering ... dentistry for more than 5 years. A leading cause of emergency room visits, ... treatment is not timely. , Sedation dentistry provides an anxiety-free dental ...
(Date:10/13/2015)... ... ... According to an ESPN report published on October 1, Chicago ... him in the left eye during the first day of practice for the season ... of setbacks, including a knee injury that has interfered with his ability to stay ...
(Date:10/13/2015)... ... October 13, 2015 , ... ... developed valuable new strategies for enrolling and serving insurance consumers who do not ... health insurance and pay monthly premiums. In “Health Plan Engagement Strategies: The ABCs ...
(Date:10/13/2015)... ... October 13, 2015 , ... Just under three months ... eMarketing Concepts began a $1 promotion – effectively offering all of their services for ... within weeks the company was flooded with phone calls from interested buyers. As a ...
(Date:10/13/2015)... ... , ... The Bill Howe Family of Companies is an award winning HVAC ... remediation services. Family-owned and operated for 35 years, they have maintained value, ethics and ... two years in a row from the Union Tribune Reader’s Poll, a Healthiest Company ...
Breaking Medicine News(10 mins):
(Date:10/12/2015)... 2015 Given the intricacy of the ... to deliver an ophthalmic drug effectively to a specific ocular ... ocular drug delivery. These include dilution of a drug by ... conjunctiva and drug permeation issues with respect to the cornea, ... eye drops, is lost due to the aforementioned barriers. ...
(Date:10/12/2015)... N.J. , Oct. 12, 2015  Shareholder rights ... a securities fraud class action complaint was filed in ... Jersey.  The complaint alleges that officers and directors of ... Act of 1934 between September 15, 2015 and October ... about Amicus Therapeutics, business prospects.  Amicus is a biopharmaceutical ...
(Date:10/12/2015)... 12, 2015  Millions of smokers worldwide have used ... of tobacco. An April 2015 study released ... showed electronic cigarettes to be up to 95 percent ... a decade after the technology was first introduced the ... --> --> Palm ...
Breaking Medicine Technology: