Author | Golub, Jonathan E. | |
Author | Saraceni, Valeria | |
Author | Cavalcante, Solange C. | |
Author | Pacheco, Antonio G. | |
Author | Moulton, Lawrence H. | |
Author | King, Bonnie S. | |
Author | Efron, Anne | |
Author | Moore, Richard D. | |
Author | Chaisson, Richard E. | |
Author | Durovni, Betina | |
Access date | 2023-04-20T01:28:00Z | |
Available date | 2023-04-20T01:28:00Z | |
Document date | 2007 | |
Citation | GOLUB, Jonathan E. et al. The impact of antiretroviral therapy and isoniazid preventive therapy on tuberculosis incidence in HIV-infected patients in Rio de Janeiro, Brazil. AIDS, v. 21, n. 11, p. 1441-1448, July 11, 2007. | en_US |
ISSN | 0269-9370 | en_US |
URI | https://www.arca.fiocruz.br/handle/icict/57903 | |
Sponsorship | This work was supported by a Bill and Melinda Gates Foundation grant for the Consortium to Respond Effectively to the AIDS–TB Epidemic (CREATE) and National Institutes of Health grants AI066994 and AI001637. | en_US |
Language | eng | en_US |
Publisher | Lippincott, Williams & Wilkins | en_US |
Rights | open access | en_US |
Title | The impact of antiretroviral therapy and isoniazid preventive therapy on tuberculosis incidence in HIV-infected patients in Rio de Janeiro, Brazil | en_US |
Type | Article | en_US |
DOI | 10.1097/QAD.0b013e328216f441 | |
Abstract | Background—Tuberculosis is a common complication and leading cause of death in HIV infection. Antiretroviral therapy (ART) lowers the risk of tuberculosis, but may not be sufficient to control HIV-related tuberculosis. Isoniazid preventive therapy (IPT) reduces tuberculosis incidence significantly, but is not widely used. Methods—We analysed tuberculosis incidence in 11 026 HIV-infected patients receiving medical care at 29 public clinics in Rio de Janeiro, Brazil, between 1 September 2003 and 1 September 2005. Data were collected through a retrospective medical record review. We determined rates of tuberculosis in patients who received neither ART nor IPT, only ART, only IPT, or both ART and IPT. Results—The overall tuberculosis incidence was 2.28 cases/100 person-years (PY) [95% confidence interval (CI) 2.06–2.52]. Among patients who received neither ART nor IPT, incidence was 4.01/100 PY. Patients who received ART had an incidence of 1.90/100 PY (95% CI 1.66– 2.17) and those treated with IPT had a rate of 1.27/100 PY (95% CI 0.41–2.95). The incidence among patients who received ART and IPT was 0.80/100 PY (95% CI 0.38–1.47). Multivariate Cox proportional hazards modeling revealed a 76% reduction in tuberculosis risk among patients receiving both ART and IPT (adjusted relative hazard 0.24; P < 0.001) after adjusting for age, previous tuberculosis diagnosis, and CD4 cell counts at baseline. Conclusion—The use of both IPT and ART in HIV-infected patients is associated with significantly reduced tuberculosis incidence. In conjunction with expanded access to ART, the wider use of IPT in patients with HIV will improve tuberculosis control in high burden areas. | en_US |
Affilliation | Johns Hopkins University. Center for Tuberculosis Research and Departments of Medicine and International Health. Baltimore, Maryland, USA. | en_US |
Affilliation | Municipal Health Secretariat. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Municipal Health Secretariat. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Instituto Nacional de Pesquisas Evandro Chagas. Rio de Janeiro, RJ, Brazil / Federal University of Rio de Janeiro. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Municipal Health Secretariat. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Instituto Nacional de Pesquisas Evandro Chagas. Rio de Janeiro, RJ, Brazil / Federal University of Rio de Janeiro. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Johns Hopkins University. Center for Tuberculosis Research and Departments of Medicine and International Health. Baltimore, Maryland, USA. | en_US |
Affilliation | Johns Hopkins University. Center for Tuberculosis Research and Departments of Medicine and International Health. Baltimore, Maryland, USA. | en_US |
Affilliation | Johns Hopkins University. Center for Tuberculosis Research and Departments of Medicine and International Health. Baltimore, Maryland, USA. | en_US |
Affilliation | Johns Hopkins University. Center for Tuberculosis Research and Departments of Medicine and International Health. Baltimore, Maryland, USA. | en_US |
Affilliation | Johns Hopkins University. Center for Tuberculosis Research and Departments of Medicine and International Health. Baltimore, Maryland, USA. | en_US |
Affilliation | Municipal Health Secretariat. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Instituto Nacional de Pesquisas Evandro Chagas. Rio de Janeiro, RJ, Brazil / Federal University of Rio de Janeiro. Rio de Janeiro, RJ, Brazil. | en_US |
Subject | Antiretroviral therapy | en_US |
Subject | Brazil | en_US |
Subject | HIV | en_US |
Subject | Isoniazid | en_US |
Subject | Tuberculosis | en_US |
e-ISSN | 1473-5571 | |