title: Time to initiation of antiretroviral therapy among patients with HIV-associated tuberculosis in Cape Town, South Africa.
abstract: We studied the time interval between starting tuberculosis treatment and commencing antiretroviral treatment (ART) in HIV-infected patients (n = 1433; median CD4 count 71 cells per microliter, interquartile range: 32-132) attending 3 South African township ART services between 2002 and 2008. The overall median delay was 2.66 months (interquartile range: 1.58-4.17). In adjusted analyses, delays varied between treatment sites but were shorter for patients with lower CD4 counts and those treated in more recent calendar years. During the most recent period (2007-2008), 4.7%, 19.7%, and 51.1% of patients started ART within 2, 4, and 8 weeks of tuberculosis treatment, respectively. Operational barriers must be tackled to permit further acceleration of ART initiation as recommended by 2010 WHO ART guidelines.
authors: The Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa. stevelawn@yahoo.co.uk
authors: Stephen D
authors: SD
authors: Lawn
authors: Lucy
authors: L
authors: Campbell
authors: Richard
authors: R
authors: Kaplan
authors: Andrew
authors: A
authors: Boulle
authors: Morna
authors: M
authors: Cornell
authors: Bernhard
authors: B
authors: Kerschberger
authors: Carl
authors: C
authors: Morrow
authors: Francesca
authors: F
authors: Little
authors: Matthias
authors: M
authors: Egger
authors: Robin
authors: R
authors: Wood
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013019:South Africa / Q000453:epidemiology; D013997:Time Factors; D014376:Tuberculosis / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D000995:Antitubercular Agents