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Combined Drug Therapy to Treat TB and HIV Significantly Improves Survival

Posted Feb 25 2010 3:20pm

Initiating antiretroviral therapy (ART) during tuberculosis therapy significantly reduced mortality rates by 56 percent in a randomized clinical trial of 642 patients co-infected with HIV and tuberculosis. The study, which provides further impetus for the integration of TB and HIV services, lays to rest the controversy on whether co-infected patients should initiate ART during or after TB treatment. Findings are published in the February 25th issue of The New England Journal of Medicine.

Tuberculosis is the most common opportunistic disease and the most frequent cause of death in patients with HIV infection in developing countries, and the number of patients with co-infection continues to grow rapidly.

“Despite World Health Organization(WHO) guidelines supporting concomitant treatment of the two diseases and urging more aggressive management initiation of antiretroviral therapy, treatment often has been deferred until completion of tuberculosis therapy because of concern about potential drug interactions, overlapping side effects, a high pill burden, and programmatic challenges,” said Salim S. Abdool Karim, MD, PhD, professor of clinical epidemiology at Columbia University’s Mailman School of Public Health, pro vice-chancellor (research) at the University of KwaZulu-Natal in Durban, South Africa, and principal investigator of the study.

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