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Tuberculosis After HAART Initiation in HIV-Positive Patients from Five Countries with a High Tuberculosis Burden.

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dc.contributor MSF Epicentre, Médecins Sans Frontieres, Paris, France. maryline.bonnet@geneva.msf.org
dc.creator Bonnet, M
dc.creator Pinoges, L
dc.creator Varaine, F
dc.creator Oberhauser, B O
dc.creator O'Brien, D P
dc.creator Kebede, Y
dc.creator Hewison, C
dc.creator Zachariah, R
dc.creator Ferradini, L
dc.date 2006-06-12
dc.date.accessioned 2017-01-31T07:10:01Z
dc.date.available 2017-01-31T07:10:01Z
dc.identifier Tuberculosis After HAART Initiation in HIV-Positive Patients from Five Countries with a High Tuberculosis Burden. 2006, 20 (9):1275-9 AIDS
dc.identifier 0269-9370
dc.identifier 16816556
dc.identifier 10.1097/01.aids.0000232235.26630.ee
dc.identifier http://hdl.handle.net/10144/18313
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/18313
dc.identifier AIDS
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/18313
dc.description BACKGROUND: HAART reduces tuberculosis (TB) incidence in people living with HIV/AIDS but those starting HAART may develop active TB or subclinical TB may become apparent in the immune reconstitution inflammatory syndrome. OBJECTIVE: To measure the incidence rate of notified TB in people receiving HAART in five HIV programmes occurring in low-resource countries with a high TB/HIV burden. METHODS: A retrospective review in five Médecins Sans Frontières programmes (Cambodia, Thailand, Kenya, Malawi and Cameroon) allowed incidence rates of notified TB to be calculated based on follow-up time after HAART initiation. RESULT: Among 3151 patients analysed, 90% had a CD4 cell count of < 200 cells/mul. Median follow-up time ranged from 3.7 months in Thailand or Kenya to 11.1 months in Cambodia. Incidence rates were 7.6, 10.4, 17.6, 14.3 and 4.8/100 person-years for pulmonary TB and 12.7, 4.3, 6.9, 2.1 and 0/100 person-years for extra-pulmonary TB in the programmes in Cambodia, Thailand, Kenya, Malawi and Cameroon, respectively. Overall, 62.3% of pulmonary TB and 54.9% of extra-pulmonary TB were diagnosed within 3 months after HAART initiation. CONCLUSION: High incidence rates of notified TB under HAART in programmes held in poor-resource countries were observed; these were likely to include both undiagnosed prevalent TB at HAART initiation and subclinical TB developing during the immune reconstitution inflammatory syndrome. This raises operational issues concerning TB diagnosis and treatment of TB/HIV-coinfected patients and prompts for urgent TB and HIV care integration.
dc.language en
dc.rights Published by Wolters Kluwer Lippincott Williams & Wilkins - Archived on this site by kind permission Wolters Kluwer
dc.title Tuberculosis After HAART Initiation in HIV-Positive Patients from Five Countries with a High Tuberculosis Burden.


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