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Predictors of Tuberculosis in First 6 Months After Initiation of Antiretroviral Therapy: A Case-Control Study.

Peck, R. N., Luhanga, A., Kalluvya, S., Todd, J., Lugoba, S., Fitzgerald, D. W. and Downs, J. A. (2012) Predictors of Tuberculosis in First 6 Months After Initiation of Antiretroviral Therapy: A Case-Control Study. The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 16 (8). pp. 1047-51. ISSN 1815-7920

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Abstract

In Africa, 10% of human immunodeficiency virus (HIV) infected adults starting antiretroviral therapy (ART) die within the first year, and tuberculosis (TB) is the leading cause of death. To investigate the predictors of ART-associated TB at an adult HIV clinic in Tanzania. In this nested case-control study, adults starting ART were screened for TB according to the World Health Organization protocol. Those not diagnosed with TB were observed for 6 months. Patients diagnosed with TB were defined as cases, and controls were selected from among the patients who did not develop TB using incidence density matching. Among the 2514 HIV-positive adults in our cohort, 72 (3%) were diagnosed with TB during the first 6 months of ART. By multivariate analysis, baseline characteristics predictive of TB were cough, fever and night sweats; 76% (55/72) of the cases had at least one of these symptoms at the time of starting ART. Overall, 75% of the patients who developed TB during the first 6 months of ART had TB symptoms at the time of starting ART. Improved TB diagnostics and/or better strategies for empirical anti-tuberculosis treatment are needed for patients with symptoms of TB at ART initiation.

Item Type: Article
Keywords: HIV, Mortality, antiretroviral, tuberculosis, Adult, Tanzania
Subjects: HIV > Surveillance
Tuberculosis > Diagnosis
Divisions: Catholic University of Health and Allied Sciences (CUHAS)
Depositing User: Mr Joseph Madata
Date Deposited: 05 Dec 2013 06:53
Last Modified: 05 Dec 2013 06:53
URI: http://ihi.eprints.org/id/eprint/1452

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