Low uptake of antiretroviral therapy after admission with human immunodeficiency virus and tuberculosis in KwaZulu-Natal, South Africa

被引：0

作者：

Murphy, R. A. ^{[1
]}

Sunpath, H. ^{[2
]}

Taha, B. ^{[3
]}

Kappagoda, S. ^{[4
]}

Maphasa, K. T. M. ^{[5
]}

Kuritzkes, D. R. ^{[6
]}

Smeaton, L. ^{[7
]}

机构：

[1] Doctors Borders USA, New York, NY 10001 USA

[2] McCord Hosp, Durban, South Africa

[3] Harvard Univ, Sch Med, Boston, MA USA

[4] Stanford Univ, Div Infect Dis & Geog Med, Palo Alto, CA 94304 USA

[5] Zoe Life, Durban, South Africa

[6] Brigham & Womens Hosp, Sect Retroviral Therapeut, Boston, MA 02115 USA

[7] Harvard Univ, Sch Publ Hlth, Ctr Biostat AIDS Res, Boston, MA 02115 USA

来源：

INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE | 2010年 / 14卷 / 07期

基金：

美国国家卫生研究院;

关键词：

co-infection; tuberculosis; antiretroviral therapy;

D O I：

暂无

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

OBJECTIVES: A prospective cohort study was conducted among human immunodeficiency virus (HIV) infected inpatients with tuberculosis (TB) or other opportunistic infections (OIs) in South Africa to estimate subsequent antiretroviral therapy (ART) uptake and survival. METHODS: Logistic regression modeling explored associations between baseline characteristics and starting ART, and ART exposure-adjusted incidence of death was estimated over 6 months of follow-up. RESULTS: Among 49 participants enrolled, median CD4 cell count at hospital discharge was 42 cells/mu l and the most common presenting OIs were TB (76%), Pneumocystis pneumonia (8%), chronic diarrhea (8%), cryptococcal meningitis (6%), and Toxoplasma gondii (4%). By 6 months, only 20 (45%) patients had initiated ART, and four (8%) were lost to follow-up. ART uptake was independently associated with previous use of traditional medicine (OR 7.2, 95% CI 1.4-55.1) and with less advanced HIV infection (baseline CD4 count per 50 cells/mu l increase OR 1.4, 95% CI 0.9-2.2). A total of 14 (31%) patients died before initiating ART; the monthly incidence of death did not decrease over the 6-month interval. CONCLUSION: The high mortality observed within the 6 months following hospitalization with TB or other acute OIs indicate that mechanisms are needed to expedite ART for patients after an acquired immune-deficiency syndrome defining illness.

引用

页码：903 / 908

页数：6