title: Results of rapid and successful integration of HIV diagnosis and care into tuberculosis services in Benin.
abstract: METHODS
  Benin, where 20 of 54 tuberculosis (TB) clinics caring for 80% of all TB patients began providing integrated human immunodeficiency virus (HIV) care in 2005.
  
  
  OBJECTIVE
  To describe the characteristics and TB treatment outcomes of the first cohorts of TB-HIV patients, and to assess programmatic outcomes.
  
  
  METHODS
  Retrospective cohort study using data from the TB register and the register of co-infected patients.
  
  
  RESULTS
  During the study period, 8368 TB patients were registered, 7787 (93%) were tested for HIV and 1255 (16%) were HIV-positive, including 385 (32%) who already knew their positive status. Most patients (88%) were tested within 15 days of TB diagnosis. Female and young patients were overrepresented among the co-infected. Cotrimoxazole preventive therapy was administered to 1152 patients (95%) during anti-tuberculosis treatment, and antiretroviral treatment (ART) to 469 (42%). The likelihood of receiving ART increased as initial CD4 lymphocyte counts decreased. Fifteen per cent of TB-HIV patients died during anti-tuberculosis treatment. Patients already on ART prior to anti-tuberculosis treatment experienced the worst outcomes. Patients who initiated ART early during anti-tuberculosis treatment or in the timeframe recommended by the guidelines fared the best.
  
  
  CONCLUSIONS
  HIV care has been successfully and sustainably integrated into TB services in Benin. However, ensuring the access of co-infected patients to more favourable treatment outcomes still represents significant challenges.
authors.affiliation: International Union Against Tuberculosis and Lung Disease, Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Ferroussier
authors.forename: R A
authors.initials: RA
authors.lastname: Dlodlo
authors.forename: D
authors.initials: D
authors.lastname: Capo-Chichi
authors.forename: F
authors.initials: F
authors.lastname: Boillot
authors.forename: M
authors.initials: M
authors.lastname: Gninafon
authors.forename: A
authors.initials: A
authors.lastname: Trébucq
authors.forename: P I
authors.initials: PI
authors.lastname: Fujiwara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001541:Benin / Q000453:epidemiology; D060085:Coinfection; D003376:Counseling; D019033:Delivery of Health Care, Integrated; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016730:Program Development; D015397:Program Evaluation; D012042:Registries; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D000995:Antitubercular Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination