title: Antiretroviral therapy during tuberculosis treatment and marked reduction in death rate of HIV-infected patients, Thailand.
abstract: Antiretroviral therapy (ART) is lifesaving in patients with advanced HIV infection, but the magnitude of benefit in HIV-infected patients receiving tuberculosis (TB) treatment remains uncertain, and population-based data from developing countries are limited. We prospectively collected data about HIV-infected TB patients from February 2003 through January 2004 in Ubon-ratchathani, Thailand. During 12 months, HIV was diagnosed in 329 (14%) of 2,342 patients registered for TB treatment. Of patients with known outcomes, death during TB treatment occurred in 5 (7%) of 71 who received ART and 94 (43%) of 219 who did not. Using multivariate analysis, we found a large reduction in the odds of death for patients receiving ART before or during TB treatment (odds ratio, 0.2; 95% confidence interval, 0.1-0.5), adjusting for CD4 count, smear status, co-trimoxazole use, and treatment facility. ART is associated with a substantial reduction in deaths during TB treatment for HIV-infected TB patients in Thailand.
authors.affiliation: Ministry of Public Health, Ubon-ratchathani, Thailand.
authors.forename: Somsak
authors.initials: S
authors.lastname: Akksilp
authors.forename: Opart
authors.initials: O
authors.lastname: Karnkawinpong
authors.forename: Wanpen
authors.initials: W
authors.lastname: Wattanaamornkiat
authors.forename: Daranee
authors.initials: D
authors.lastname: Viriyakitja
authors.forename: Patama
authors.initials: P
authors.lastname: Monkongdee
authors.forename: Walya
authors.initials: W
authors.lastname: Sitti
authors.forename: Dhanida
authors.initials: D
authors.lastname: Rienthong
authors.forename: Taweesap
authors.initials: T
authors.lastname: Siraprapasiri
authors.forename: Charles D
authors.initials: CD
authors.lastname: Wells
authors.forename: Jordan W
authors.initials: JW
authors.lastname: Tappero
authors.forename: Jay K
authors.initials: JK
authors.lastname: Varma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000401:mortality*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D013785:Thailand; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy / Q000401:mortality*
chemical_list: D019380:Anti-HIV Agents; D044966:Anti-Retroviral Agents; D000995:Antitubercular Agents