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A Randomized Trial of Punctuated Antiretroviral Therapy in Ugandan HIV-Seropositive Adults With Pulmonary Tuberculosis and CD4+ T-Cell Counts of ≥350 cells/μL.
- Source :
- Journal of Infectious Diseases; 9/15/2011, Vol. 204 Issue 6, p884-992, 9p
- Publication Year :
- 2011
-
Abstract
- Background. Optimal treatment of human immunodeficiency virus (HIV)-associated tuberculosis in patients with high CD4<superscript>+</superscript> T-cell counts is unknown. Suppression of viral replication during therapy for tuberculosis may block effects of immune activation on T cells and slow HIV disease progression. Methods. We conducted a randomized trial in 214 HIV-infected patients with active tuberculosis and CD4<superscript>+</superscript> T-cell counts of ≥350 cells/μL to determine whether 6 months of antiretroviral therapy given during tuberculosis treatment would improve clinical outcomes. Subjects were randomized to receive 6 months of abacavir-lamivudine-zidovudine concurrent with tuberculosis therapy or delayed antiretroviral therapy. Endpoints were CD4<superscript>+</superscript> T-cell counts of <250 cells/μL, AIDS, or death. Results. Intervention and comparison arms had similar median CD4<superscript>+</superscript> counts (517 and 534 cells/μL, respectively) and HIV RNA levels (4.6 and 4.7 log<subscript>10</subscript> copies/μL, respectively). Viral suppression was achieved in 86% of patients allocated to intervention. Seventeen subjects (15.6%) in the intervention arm developed study outcome compared to 25 subjects (22.8%) in the comparison arm (P = .17). Grade 3 or 4 adverse events were less frequent in the intervention arm. By 2 months, 90% of subjects in both arms were culture-negative for tuberculosis. Conclusions. Short-term antiretroviral therapy during tuberculosis treatment in patients with CD4<superscript>+</superscript> T-cell counts of >350 cells/μL was safe and associated with clinical benefits. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00221899
- Volume :
- 204
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Journal of Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 73743144
- Full Text :
- https://doi.org/10.1093/infdis/jir503