title: Utility of tuberculosis directly observed therapy programs as sites for access to and provision of antiretroviral therapy in resource-limited countries.
abstract: The overwhelming share of the global human immunodeficiency virus (HIV) infection and disease burden is borne by resource-limited countries. The explosive spread of HIV infection and growing burden of disease in these countries has intensified the need to find solutions to improved access to treatment for HIV infection. The epidemic of HIV infection and acquired immune deficiency syndrome (AIDS) has been accompanied by a severe epidemic of tuberculosis. Tuberculosis has become the major cause of morbidity and mortality in patients with HIV disease worldwide. Among the various models of provision of HIV/AIDS care, one logical but unexplored strategy is to integrate HIV/AIDS and tuberculosis care and treatment, including highly active antiretroviral therapy, through existing tuberculosis directly observed therapy programs. This strategy could address the related issues of inadequate access and infrastructure and need for enhanced adherence to medication and thereby potentially improve the outcome for both diseases.
authors.affiliation: AIDS Program, Yale University School of Medicine, New Haven, Connecticut 06510-2483, USA. gerald.friedland@yale.edu
authors.forename: Gerald
authors.initials: G
authors.lastname: Friedland
authors.forename: Salim
authors.initials: S
authors.lastname: Abdool Karim
authors.forename: Quarraisha
authors.initials: Q
authors.lastname: Abdool Karim
authors.forename: Umesh
authors.initials: U
authors.lastname: Lalloo
authors.forename: Christopher
authors.initials: C
authors.lastname: Jack
authors.forename: Neel
authors.initials: N
authors.lastname: Gandhi
authors.forename: Wafaa
authors.initials: W
authors.lastname: El Sadr
mesh_terms: D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023801:Directly Observed Therapy / Q000379:methods*; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006295:Health Resources; D006801:Humans; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality
chemical_list: D019380:Anti-HIV Agents; D000995:Antitubercular Agents