Treatment outcomes of patients co-infected with HIV and tuberculosis who received a nevirapine-based antiretroviral regimen: A four-year prospective study
Background: The concurrent use of nevirapine-based antiretroviral therapy (ART) and rifampin-containing anti-tuberculosis regimens for the treatment of HIV and tuberculosis (TB) is common in resource-limited countries. Long-term outcomes of this concurrent treatment are unknown. Methods: Seventy HIV...
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th-mahidol.294792018-09-24T16:18:44Z Treatment outcomes of patients co-infected with HIV and tuberculosis who received a nevirapine-based antiretroviral regimen: A four-year prospective study Weerawat Manosuthi Preecha Tantanathip Sukanya Chimsuntorn Boonchuay Eampokarap Supeda Thongyen Samruay Nilkamhang Somnuek Sungkanuparph Thailand Ministry of Public Health Mahidol University Medicine Background: The concurrent use of nevirapine-based antiretroviral therapy (ART) and rifampin-containing anti-tuberculosis regimens for the treatment of HIV and tuberculosis (TB) is common in resource-limited countries. Long-term outcomes of this concurrent treatment are unknown. Methods: Seventy HIV-infected patients receiving rifampin for active TB (TB group) and 70 HIV-mono-infected patients (control group) were enrolled to receive nevirapine 400. mg/day-based ART. All were followed through 4 years of ART. Plasma HIV-1 RNA and CD4 cell counts were monitored every 12 weeks until 96 weeks, and every 24 weeks thereafter. Results: Of the 140 patients, the median (interquartile range (IQR)) CD4 count was 31 (14-79) cells/mm3and median (IQR) plasma HIV-1 RNA was 5.6 (5.2-5.9) log copies/ml at baseline Thirty-nine (55.7%) patients in the TB group were diagnosed with extrapulmonary/disseminated TB. The median duration of concurrent administration of nevirapine and rifampin was 5.4 (4.6-6.1) months. By intention-to-treat analysis, the percentage of patients who achieved HIV-1 RNA <50 copies/ml was 52.9% in the TB group and 50% in control group (p=0.866; odds ratio 1.121, 95% confidence interval 0.578-2.176); median (IQR) CD4 counts were 352 (271-580) cells/mm3and 425 (308-615) cells/mm3in the corresponding groups (p=0.238). The proportion of ART discontinuation due to any reason at 1, 2, 3, and 4 years was 21%, 34%, 37%, and 46% in the TB group and 21%, 36%, 43%, and 49% in the control group, respectively (p=0.651). The 4-year mortality rate was 6.4% in both groups. Conclusions: Nevirapine-based ART is an option for HIV-infected patients who receive rifampin in resource-limited countries or those who cannot tolerate efavirenz. © 2010 International Society for Infectious Diseases. 2018-09-24T09:18:44Z 2018-09-24T09:18:44Z 2010-11-01 Article International Journal of Infectious Diseases. Vol.14, No.11 (2010) 10.1016/j.ijid.2010.06.016 12019712 2-s2.0-78149468114 https://repository.li.mahidol.ac.th/handle/123456789/29479 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=78149468114&origin=inward |
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Medicine Weerawat Manosuthi Preecha Tantanathip Sukanya Chimsuntorn Boonchuay Eampokarap Supeda Thongyen Samruay Nilkamhang Somnuek Sungkanuparph Treatment outcomes of patients co-infected with HIV and tuberculosis who received a nevirapine-based antiretroviral regimen: A four-year prospective study |
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Background: The concurrent use of nevirapine-based antiretroviral therapy (ART) and rifampin-containing anti-tuberculosis regimens for the treatment of HIV and tuberculosis (TB) is common in resource-limited countries. Long-term outcomes of this concurrent treatment are unknown. Methods: Seventy HIV-infected patients receiving rifampin for active TB (TB group) and 70 HIV-mono-infected patients (control group) were enrolled to receive nevirapine 400. mg/day-based ART. All were followed through 4 years of ART. Plasma HIV-1 RNA and CD4 cell counts were monitored every 12 weeks until 96 weeks, and every 24 weeks thereafter. Results: Of the 140 patients, the median (interquartile range (IQR)) CD4 count was 31 (14-79) cells/mm3and median (IQR) plasma HIV-1 RNA was 5.6 (5.2-5.9) log copies/ml at baseline Thirty-nine (55.7%) patients in the TB group were diagnosed with extrapulmonary/disseminated TB. The median duration of concurrent administration of nevirapine and rifampin was 5.4 (4.6-6.1) months. By intention-to-treat analysis, the percentage of patients who achieved HIV-1 RNA <50 copies/ml was 52.9% in the TB group and 50% in control group (p=0.866; odds ratio 1.121, 95% confidence interval 0.578-2.176); median (IQR) CD4 counts were 352 (271-580) cells/mm3and 425 (308-615) cells/mm3in the corresponding groups (p=0.238). The proportion of ART discontinuation due to any reason at 1, 2, 3, and 4 years was 21%, 34%, 37%, and 46% in the TB group and 21%, 36%, 43%, and 49% in the control group, respectively (p=0.651). The 4-year mortality rate was 6.4% in both groups. Conclusions: Nevirapine-based ART is an option for HIV-infected patients who receive rifampin in resource-limited countries or those who cannot tolerate efavirenz. © 2010 International Society for Infectious Diseases. |
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Thailand Ministry of Public Health |
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Thailand Ministry of Public Health Weerawat Manosuthi Preecha Tantanathip Sukanya Chimsuntorn Boonchuay Eampokarap Supeda Thongyen Samruay Nilkamhang Somnuek Sungkanuparph |
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Article |
author |
Weerawat Manosuthi Preecha Tantanathip Sukanya Chimsuntorn Boonchuay Eampokarap Supeda Thongyen Samruay Nilkamhang Somnuek Sungkanuparph |
author_sort |
Weerawat Manosuthi |
title |
Treatment outcomes of patients co-infected with HIV and tuberculosis who received a nevirapine-based antiretroviral regimen: A four-year prospective study |
title_short |
Treatment outcomes of patients co-infected with HIV and tuberculosis who received a nevirapine-based antiretroviral regimen: A four-year prospective study |
title_full |
Treatment outcomes of patients co-infected with HIV and tuberculosis who received a nevirapine-based antiretroviral regimen: A four-year prospective study |
title_fullStr |
Treatment outcomes of patients co-infected with HIV and tuberculosis who received a nevirapine-based antiretroviral regimen: A four-year prospective study |
title_full_unstemmed |
Treatment outcomes of patients co-infected with HIV and tuberculosis who received a nevirapine-based antiretroviral regimen: A four-year prospective study |
title_sort |
treatment outcomes of patients co-infected with hiv and tuberculosis who received a nevirapine-based antiretroviral regimen: a four-year prospective study |
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2018 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/29479 |
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1763494906456702976 |