Use of anti-retroviral therapy in tuberculosis patients on second-line anti-TB regimens: a systematic review.
Use of anti-retroviral therapy in tuberculosis patients on second-line anti-TB regimens: a systematic review.
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DOI：
10.1371/journal.pone.0047370
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
ART study group
中科院分区：
文献类型：
--
作者：
Arentz M;Pavlinac P;Kimerling ME;Horne DJ;Falzon D;Schünemann HJ;Royce S;Dheda K;Walson JL;ART study group
在治疗药物敏感性结核病（TB）期间使用抗逆转录病毒疗法（ART）可提高生存率。然而，缺乏艾滋病毒感染者耐药结核病的数据。二线结核病药物与抗逆转录病毒疗法联合使用可能会增加药物相互作用，导致更高的毒性和更大的不依从性。本系统评价旨在确定ART在耐药结核病二线药物治疗中的获益。我们纳入了1980年1月至2009年12月期间发表的评价HIV-1感染者耐药结核病治疗的研究中的个体患者数据。我们评估了ART对治疗结果、涂片和培养转换时间以及不良事件的影响。分析了10项观察性研究，包括217例受试者的数据。在结核病治疗期间使用抗逆转录病毒疗法的患者在耐药结核病治疗期间治愈的可能性增加（风险比（HR）3.4，95% CI 1.6-7.4），死亡的可能性降低（HR 0.4，95% CI 0.3-0.6）。在CD 4小于200个细胞/mm 3和小于50个细胞/mm 3的患者中，以及校正耐药模式时，这些相关性仍然显著。我们仅确定了可以从中提取个体患者数据的观察性研究。研究设计的局限性和许多关注结果的异质性有可能引入偏倚。虽然没有足够的数据来确定当与二线TB药物一起使用时，ART的使用是否会增加不良药物相互作用，但在耐药TB治疗期间使用ART似乎可以提高治愈率并降低死亡风险。所有艾滋病毒感染者似乎都受益于结核病治疗期间使用抗逆转录病毒疗法。
Use of antiretroviral therapy (ART) during treatment of drug susceptible tuberculosis (TB) improves survival. However, data from HIV infected individuals with drug resistant TB are lacking. Second line TB drugs when combined with ART may increase drug interactions and lead to higher rates of toxicity and greater noncompliance. This systematic review sought to determine the benefit of ART in the setting of second line drug therapy for drug resistant TB. We included individual patient data from studies that evaluated treatment of drug-resistant tuberculosis in HIV-1 infected individuals published between January 1980 and December of 2009. We evaluated the effect of ART on treatment outcomes, time to smear and culture conversion, and adverse events. Ten observational studies, including data from 217 subjects, were analyzed. Patients using ART during TB treatment had increased likelihood of cure (hazard ratio (HR) 3.4, 95% CI 1.6–7.4) and decreased likelihood of death (HR 0.4, 95% CI 0.3–0.6) during treatment for drug resistant TB. These associations remained significant in patients with a CD4 less than 200 cells/mm3 and less than 50 cells/mm3, and when correcting for drug resistance pattern. We identified only observational studies from which individual patient data could be drawn. Limitations in study design, and heterogeneity in a number of the outcomes of interest had the potential to introduce bias. While there are insufficient data to determine if ART use increases adverse drug interactions when used with second line TB drugs, ART use during treatment of drug resistant TB appears to improve cure rates and decrease risk of death. All individuals with HIV appear to benefit from ART use during treatment for TB.
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DOI：
10.1056/nejmoa1013607
发表时间：
2011-10-20
期刊：
The New England journal of medicine
影响因子：
--
作者：
Havlir DV;Kendall MA;Ive P;Kumwenda J;Swindells S;Qasba SS;Luetkemeyer AF;Hogg E;Rooney JF;Wu X;Hosseinipour MC;Lalloo U;Veloso VG;Some FF;Kumarasamy N;Padayatchi N;Santos BR;Reid S;Hakim J;Mohapi L;Mugyenyi P;Sanchez J;Lama JR;Pape JW;Sanchez A;Asmelash A;Moko E;Sawe F;Andersen J;Sanne I;AIDS Clinical Trials Group Study A5221
通讯作者：
AIDS Clinical Trials Group Study A5221
影响因子：
11.8
作者：
Eker, Barbara;Ortmann, Johannes;Migliori, Giovanni B.;Sotgiu, Giovanni;Muetterlein, Ralf;Centis, Rosella;Hoffmann, Harald;Kirsten, Detlef;Schaberg, Tom;Ruesch-Gerdes, Sabine;Lange, Christoph
通讯作者：
Lange, Christoph
DOI：
10.1056/nejmoa0905848
发表时间：
2010-02-25
期刊：
The New England journal of medicine
影响因子：
--
作者：
Abdool Karim SS;Naidoo K;Grobler A;Padayatchi N;Baxter C;Gray A;Gengiah T;Nair G;Bamber S;Singh A;Khan M;Pienaar J;El-Sadr W;Friedland G;Abdool Karim Q
通讯作者：
Abdool Karim Q
DOI：
10.1056/nejmoa1013911
发表时间：
2011-10-20
期刊：
The New England journal of medicine
影响因子：
--
作者：
Blanc FX;Sok T;Laureillard D;Borand L;Rekacewicz C;Nerrienet E;Madec Y;Marcy O;Chan S;Prak N;Kim C;Lak KK;Hak C;Dim B;Sin CI;Sun S;Guillard B;Sar B;Vong S;Fernandez M;Fox L;Delfraissy JF;Goldfeld AE;CAMELIA (ANRS 1295–CIPRA KH001) Study Team
通讯作者：
CAMELIA (ANRS 1295–CIPRA KH001) Study Team
影响因子：
28.2
作者：
El Sahly, Hana M.;Teeter, Larry D.;Graviss, Edward A.
通讯作者：
Graviss, Edward A.