Optimum time to start antiretroviral therapy in patients with HIV-associated tuberculosis: before or after tuberculosis diagnosis?

AIDS. 2011 Apr 24;25(7):1003-6. doi: 10.1097/QAD.0b013e328345ee32.

Abstract

WHO policy states that tuberculosis (TB) should be diagnosed and treated before starting antiretroviral treatment (ART). However, during the pre-ART screening period, diagnosing or excluding TB can be a lengthy process and may cause undesirable delays in ART initiation. In this observational study from South Africa, we report that initiation of ART before TB treatment in patients with delayed diagnoses of culture-positive prevalent TB was not associated with adverse clinical, immunological or virological outcomes during 12-month follow-up.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis
  • AIDS-Related Opportunistic Infections / drug therapy*
  • Adult
  • Anti-HIV Agents / administration & dosage*
  • Antitubercular Agents / administration & dosage*
  • CD4 Lymphocyte Count
  • Drug Administration Schedule
  • Female
  • HIV Infections / drug therapy*
  • Humans
  • Male
  • Practice Guidelines as Topic
  • Time Factors
  • Treatment Outcome
  • Tuberculosis / diagnosis
  • Tuberculosis / drug therapy*
  • Young Adult

Substances

  • Anti-HIV Agents
  • Antitubercular Agents