Improved outcomes from HIV/TB co-infection in Singapore following a switch to earlier anti-retroviral therapy

Introduction: Recent clinical trials have provided clear evidence to support early anti‐retroviral therapy (ART) in patients with HIV/TB co‐infection and low CD4 counts. We investigated how this has changed treatment and outcomes in Singapore. Materials and Methods: A retrospective review was performed with inpatient and outpatient records for all subjects diagnosed with HIV/TB co‐infection from 2006 to 2011 attending the Tuberculosis Control Unit, Tan Tock Seng Hospital, Singapore. Data for subjects with a presenting CD4 Results: One hundred thirty‐four out of 180 subjects in the database met the inclusion criteria for this study, 89 in the delayed group and 45 in the early. No statistically significant differences in baseline demographics between the two groups were identified. Both groups presented with markedly low CD4 counts, with overall 60% Conclusions: Significant improvements in HIV/TB infection outcomes correlate with the switch to earlier ART.
Figure 1: Kaplan‐Meier survival curve, censored at first event per subject. Hazard ratio for death or opportunistic infection 8.36 in the delayed ART group (CI 95: 4.02–17.36). [Figure omitted] DOI: [...]