Please use this identifier to cite or link to this item:
https://www.arca.fiocruz.br/handle/icict/35691
Type
ArticleCopyright
Open access
Embargo date
2020-03-19
Collections
- INI - Artigos de Periódicos [3460]
Metadata
Show full item record
SAFETY AND EFFECTIVENESS OF HAART IN TUBERCULOSIS-HIV CO-INFECTED PATIENTS IN BRAZIL
Author
Affilliation
Federal University of Rio de Janeiro. Clementino Fraga Filho University Hospital. Institute of Thoracic Diseases. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Federal University of Rio de Janeiro. Clementino Fraga Filho University Hospital. Institute of Thoracic Diseases. Rio de Janeiro, RJ, Brazil.
Johns Hopkins University. Baltimore, MD, USA.
Johns Hopkins University. Baltimore, MD, USA.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Federal University of Rio de Janeiro. Clementino Fraga Filho University Hospital. Institute of Thoracic Diseases. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Federal University of Rio de Janeiro. Clementino Fraga Filho University Hospital. Institute of Thoracic Diseases. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Federal University of Rio de Janeiro. Clementino Fraga Filho University Hospital. Institute of Thoracic Diseases. Rio de Janeiro, RJ, Brazil.
Johns Hopkins University. Baltimore, MD, USA.
Johns Hopkins University. Baltimore, MD, USA.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Federal University of Rio de Janeiro. Clementino Fraga Filho University Hospital. Institute of Thoracic Diseases. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto de Pesquisa Clínica Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Federal University of Rio de Janeiro. Clementino Fraga Filho University Hospital. Institute of Thoracic Diseases. Rio de Janeiro, RJ, Brazil.
Abstract
BACKGROUND — Antiretroviral therapy (ART) significantly reduces tuberculosis (TB) incidence among persons with human immunodeficiency virus (HIV), but the safety and effectiveness of concomitant treatment for both diseases remain unclear. OBJECTIVE — To evaluate the impact of ART and anti-tuberculosis treatment on survival and risk of adverse events (AE) among co-infected individuals. METHODS — In a retrospective cohort study, clinical data were collected from 618 TB-HIV patients treated with rifampin, isoniazid and pyrazinamide ± ethambutol between 1 January 1995 and 31 December 2003. Patients were categorized into two groups: highly active ART (HAART) or no ART. Different HAART regimens were evaluated. Bivariate analysis, multivariate logistic regression and survival analysis using Cox proportional hazards regression were used. RESULTS — One-year mortality was lower for patients receiving HAART (adjusted hazard ratio [aHR] 0.17, 95%CI 0.09–0.31) compared to no ART. HAART increased the risk of AE (aHR 2.08, 95%CI 1.29–3.36). The odds of AE when receiving a ritonavir + saquinavir HAART regimen was eight-fold higher compared to no ART (OR 8.31, 95%CI 3.04–22.69), while efavirenz-based HAART was not associated with a significantly increased risk of AE (OR 1.42, 95%CI 0.76–2.65). CONCLUSION — HIV patients with TB have significantly better survival if they receive HAART during anti-tuberculosis treatment. Efavirenz-based HAART is associated with fewer AEs than protease inhibitor-based HAART.
Share