Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa.
In the developing world, the principal cause of death among HIV-infected patients is tuberculosis (TB). The initiation of antiretroviral therapy (ART) during TB therapy significantly improves survival, however it is not known which barriers prevent eligible TB patients from initiating life-saving AR...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2011-05-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3093394?pdf=render |
| _version_ | 1818215244543033344 |
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| author | Dominique J Pepper Suzaan Marais Robert J Wilkinson Feriyl Bhaijee Virginia De Azevedo Graeme Meintjes |
| author_facet | Dominique J Pepper Suzaan Marais Robert J Wilkinson Feriyl Bhaijee Virginia De Azevedo Graeme Meintjes |
| author_sort | Dominique J Pepper |
| collection | DOAJ |
| description | In the developing world, the principal cause of death among HIV-infected patients is tuberculosis (TB). The initiation of antiretroviral therapy (ART) during TB therapy significantly improves survival, however it is not known which barriers prevent eligible TB patients from initiating life-saving ART.Setting. A South African township clinic with integrated tuberculosis and HIV services. Design. Logistic regression analyses of a prospective cohort of HIV-1 infected adults (≥18 years) who commenced TB therapy, were eligible for ART, and were followed for 6 months.Of 100 HIV-1 infected adults eligible for ART during TB therapy, 90 TB patients presented to an ART clinic for assessment, 66 TB patients initiated ART, and 15 TB patients died. 34% of eligible TB patients (95%CI: 25-43%) did not initiate ART. Male gender and younger age (<36 years) were associated with failure to initiate ART (adjusted odds ratios of 3.7 [95%CI: 1.25-10.95] and 3.3 [95%CI: 1.12-9.69], respectively). Death during TB therapy was associated with a CD4+ count <100 cells/µL.In a clinic with integrated services for tuberculosis and HIV, one-third of eligible TB patients--particularly young men--did not initiate ART. Strategies are needed to promote ART initiation during TB therapy, especially among young men. |
| first_indexed | 2024-12-12T06:33:00Z |
| format | Article |
| id | doaj.art-44c16cfeb1f4411c8240577581d51885 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-12T06:33:00Z |
| publishDate | 2011-05-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-44c16cfeb1f4411c8240577581d518852022-12-22T00:34:32ZengPublic Library of Science (PLoS)PLoS ONE1932-62032011-05-0165e1948410.1371/journal.pone.0019484Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa.Dominique J PepperSuzaan MaraisRobert J WilkinsonFeriyl BhaijeeVirginia De AzevedoGraeme MeintjesIn the developing world, the principal cause of death among HIV-infected patients is tuberculosis (TB). The initiation of antiretroviral therapy (ART) during TB therapy significantly improves survival, however it is not known which barriers prevent eligible TB patients from initiating life-saving ART.Setting. A South African township clinic with integrated tuberculosis and HIV services. Design. Logistic regression analyses of a prospective cohort of HIV-1 infected adults (≥18 years) who commenced TB therapy, were eligible for ART, and were followed for 6 months.Of 100 HIV-1 infected adults eligible for ART during TB therapy, 90 TB patients presented to an ART clinic for assessment, 66 TB patients initiated ART, and 15 TB patients died. 34% of eligible TB patients (95%CI: 25-43%) did not initiate ART. Male gender and younger age (<36 years) were associated with failure to initiate ART (adjusted odds ratios of 3.7 [95%CI: 1.25-10.95] and 3.3 [95%CI: 1.12-9.69], respectively). Death during TB therapy was associated with a CD4+ count <100 cells/µL.In a clinic with integrated services for tuberculosis and HIV, one-third of eligible TB patients--particularly young men--did not initiate ART. Strategies are needed to promote ART initiation during TB therapy, especially among young men.http://europepmc.org/articles/PMC3093394?pdf=render |
| spellingShingle | Dominique J Pepper Suzaan Marais Robert J Wilkinson Feriyl Bhaijee Virginia De Azevedo Graeme Meintjes Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa. PLoS ONE |
| title | Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa. |
| title_full | Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa. |
| title_fullStr | Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa. |
| title_full_unstemmed | Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa. |
| title_short | Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa. |
| title_sort | barriers to initiation of antiretrovirals during antituberculosis therapy in africa |
| url | http://europepmc.org/articles/PMC3093394?pdf=render |
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