Early Initiation of ARV Therapy Among TB-HIV Patients in Indonesia Prolongs Survival Rates!

J Epidemiol Glob Health. 2020 Jun;10(2):164-167. doi: 10.2991/jegh.k.200102.002.

Abstract

Background: The HIV epidemic remains a public health problem with rising tuberculosis (TB) numbers around the world. Antiretroviral (ARV) therapy (ART) is essential to increase the survival of patients with TB-HIV coinfection. The aim of this study is to investigate the effect of ARV treatment initiation within TB treatment duration for the survival of patients with TB-HIV coinfection.

Methods: This is a retrospective cohort study of patients with TB-HIV coinfection and who were ARV naive from Prof. Dr. Sulianti Saroso Infectious Disease Hospital between January 2011 and May 2014 (N = 275). The Kaplan-Meier method, bivariate with the log rank test, and multivariate with the Cox regression were applied in this study.

Results: Cumulative survival probability of the patients with TB-HIV coinfection receiving ARV in a year was 81.5%. The death rate in patients with TB-HIV coinfection who received late ART initiation during TB treatment is higher by 2.4 times [adjusted hazard ratio (aHR) = 2.4, 95% confidence interval: 1.3-4.5, p = 0.006] compared with the patients who were in early ART initiation and were thereafter adjusted by the location of Mycobacterium tuberculosis infection.

Conclusion: The effect of ART initiation is essential in the intensive phase (2-8 weeks) of anti-TB medication to increase the survival among TB-HIV coinfection group.

Keywords: Antiretroviral; Survival analysis; TB–HIV coinfection.

MeSH terms

  • Adult
  • Antitubercular Agents* / therapeutic use
  • Coinfection* / drug therapy
  • Coinfection* / mortality
  • Female
  • HIV Infections* / drug therapy
  • HIV Infections* / mortality
  • Humans
  • Indonesia / epidemiology
  • Male
  • Retrospective Studies
  • Survival Rate
  • Time Factors
  • Treatment Outcome
  • Tuberculosis* / drug therapy
  • Tuberculosis* / mortality

Substances

  • Antitubercular Agents