Integration of Antiretroviral Therapy with Tuberculosis Treatment

In this study from South Africa, earlier initiation of antiretroviral therapy in patients with newly diagnosed HIV infection and TB was associated with higher rates of the immune reconstitution inflammatory syndrome and adverse events but increased AIDS-free survival. In patients who have infection...

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Bibliographic Details
Published in:The New England journal of medicine Vol. 365; no. 16; pp. 1492 - 1501
Main Authors: Abdool Karim, Quarraisha, Abdool Karim, Salim S, Naidoo, Kogieleum, Naidoo, Anushka, Grobler, Anneke, Padayatchi, Nesri, Baxter, Cheryl, Gray, Andrew L, Gengiah, Tanuja, Gengiah, Santhanalakshmi, Jithoo, Niraksha, Nair, Gonasagrie, El-Sadr, Wafaa M, Friedland, Gerald
Format: Journal Article
Language:English
Published: Waltham, MA Massachusetts Medical Society 20.10.2011
Subjects:
Acquired immune deficiency syndrome
Adult
AIDS
AIDS-Related Opportunistic Infections - drug therapy
Anti-Retroviral Agents - administration & dosage
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antiretroviral agents
Antiretroviral drugs
Antiretroviral therapy
Antitubercular Agents - therapeutic use
Antiviral agents
Bacilli
Biological and medical sciences
CD4 antigen
CD4 Lymphocyte Count
Death
Disease-Free Survival
Drug Administration Schedule
Drug therapy
Female
General aspects
HIV
HIV Infections - complications
HIV Infections - drug therapy
HIV Infections - mortality
Human immunodeficiency virus
Human viral diseases
Humans
Immune reconstitution
Immunosuppressive agents
Infectious diseases
Inflammation
Kaplan-Meier Estimate
Lymphocytes T
Male
Medical sciences
Patients
Pharmacology. Drug treatments
Sputum
Tuberculosis
Tuberculosis - complications
Tuberculosis - drug therapy
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Viral Load
South Africa
Immunopathology
Antiretroviral agent
Integration
AIDS
Mycobacterial infection
Immune deficiency
Infection
Medicine
Chemotherapy
Treatment
Tuberculosis
Viral disease
Bacteriosis
Antiviral
ISSN:0028-4793, 1533-4406, 1533-4406
Online Access:Get full text
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Summary:In this study from South Africa, earlier initiation of antiretroviral therapy in patients with newly diagnosed HIV infection and TB was associated with higher rates of the immune reconstitution inflammatory syndrome and adverse events but increased AIDS-free survival. In patients who have infection with the human immunodeficiency virus (HIV) and tuberculosis, antiretroviral therapy (ART) may be initiated at the same time as or soon after the initiation of tuberculosis treatment. However, antiretroviral agents are often deferred until after the intensive phase of tuberculosis treatment because of concern about the immune reconstitution inflammatory syndrome (IRIS), 1 , 2 a high pill burden, and overlapping side effects 3 when three antiretroviral agents are added to the standard four antituberculosis drugs. These challenges may result in interruption or discontinuation of treatment for the acquired immunodeficiency syndrome (AIDS) or tuberculosis, which can lead to drug . . .
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ISSN:0028-4793
1533-4406
1533-4406
DOI:10.1056/NEJMoa1014181