Early versus delayed initiation of antiretroviral therapy for Indian HIV-Infected individuals with tuberculosis on antituberculosis treatment.
Early versus delayed initiation of antiretroviral therapy for Indian HIV-Infected individuals with tuberculosis on antituberculosis treatment.
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DOI：
10.1186/1471-2334-12-168
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发表时间：
2012-07-31
影响因子：
3.7
通讯作者：
Mitsuyasu RT
中科院分区：
文献类型：
--
作者：
Sinha S;Shekhar RC;Singh G;Shah N;Ahmad H;Kumar N;Sharma SK;Samantaray JC;Ranjan S;Ekka M;Sreenivas V;Mitsuyasu RT
对于未接受过抗逆转录病毒治疗（ART）的人类免疫缺陷病毒（HIV）感染的结核病（TB）成年患者，在开始抗结核治疗（ATT）后开始高效抗逆转录病毒治疗（HAART）的最佳时间尚不确定，以最大限度地减少死亡率、HIV疾病进展和不良事件。在印度新德里全印度医学科学研究所进行的一项随机、开放标签试验中，诊断为结核病的符合条件的艾滋病毒阳性个体在开始治疗后2-4周或8-12周后被随机分配接受HAART，并在开始治疗后进行了12个月的随访。参与者接受了针对结核病的短期直接观察治疗（DOTS），以及包括司他夫定或齐多夫定、拉米夫定和依法韦仑的抗逆转录病毒治疗方案。主要终点是任何原因的死亡，以及以ART失败为标志的HIV疾病进展。共有150例HIV和TB患者开始接受HAART治疗：88例在开始ATT后2-4周（早期ART）和62例在8-12周（延迟ART）后接受。在引入HAART后，两组之间的死亡率没有显著差异。然而，ART失败的发生率在延迟ART组为31%，而在早期ART组为16%（p = 0.045）。早期ART组12个月时Kaplan Meier疾病无进展生存率为79%，延迟ART组为64%（p = 0.05）。不良事件发生率相似。HIV和TB患者早期开始HAART可显着降低HIV疾病进展的发生率，并且具有良好的耐受性。CTRI/2011/12/002260
For antiretroviral therapy (ART) naive human immunodeficiency virus (HIV) infected adults suffering from tuberculosis (TB), there is uncertainty about the optimal time to initiate highly active antiretroviral therapy (HAART) after starting antituberculosis treatment (ATT), in order to minimize mortality, HIV disease progression, and adverse events. In a randomized, open label trial at All India Institute of Medical Sciences, New Delhi, India, eligible HIV positive individuals with a diagnosis of TB were randomly assigned to receive HAART after 2-4 or 8-12 weeks of starting ATT, and were followed for 12 months after HAART initiation. Participants received directly observed therapy short course (DOTS) for TB, and an antiretroviral regimen comprising stavudine or zidovudine, lamivudine, and efavirenz. Primary end points were death from any cause, and progression of HIV disease marked by failure of ART. A total of 150 patients with HIV and TB were initiated on HAART: 88 received it after 2-4 weeks (early ART) and 62 after 8-12 weeks (delayed ART) of starting ATT. There was no significant difference in mortality between the groups after the introduction of HAART. However, incidence of ART failure was 31% in delayed versus 16% in early ART arm (p = 0.045). Kaplan Meier disease progression free survival at 12 months was 79% for early versus 64% for the delayed ART arm (p = 0.05). Rates of adverse events were similar. Early initiation of HAART for patients with HIV and TB significantly decreases incidence of HIV disease progression and has good tolerability. CTRI/2011/12/002260
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影响因子：
6.4
作者：
Toossi, Z
通讯作者：
Toossi, Z
影响因子：
3.8
作者：
Whalen, CC;Nsubuga, P;Ellner, JJ
通讯作者：
Ellner, JJ
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：
10.1164/ajrccm.155.3.9117038
发表时间：
1997-03-01
影响因子：
24.7
作者：
Nakata, K;Rom, WN;Weiden, M
通讯作者：
Weiden, M
影响因子：
120.7
作者：
Hogg, RS;Yip, B;Montaner, JSG
通讯作者：
Montaner, JSG