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TB/HIV programmatic challenges highlighted at ICASA
Lesley Odendal, 2014-01-07 08:20:00
The presence of tuberculosis (TB) at the initiation of antiretroviral therapy (ART) predicts retention in care, according to a study presented by Dr Enegela at the 17th International Conference on AIDS and STIs in Africa (ICASA), held in Cape Town, South Africa from 7 to 11 December 2013.
Adults with TB at ART initiation were 2.85 times less likely to be retained in care (p = 0.0014; 95% CI, 1.2-6.4), according to the cross-sectional review of 1262 people who had initiated ART across 12 ARV sites in Nigeria. The review was conducted with people who had been on ART for at least nine months.
Of the 1262 study participants, 123 (9.75%) had active TB disease at ART initiation. Of these, 115 (93.5%) were retained in care, while 8 (6.5%) were not. Of the people not retained in care, three (37.5%) died, four were transferred out and one was lost to follow up.
Of the 1139 adults who did not have TB at ART initiation, 1113 (97.7%) were retained in care while 26 (2.3%) were not. Eight (30.8%) of these died during the study period, nine (34.6%) were transferred out, one (3.8%) stopped taking ART and eight (30.8%) were lost to follow-up.
“Patients with TB and HIV co-infection at ART initiation should have closer monitoring and follow up, given this study’s results. Further studies may be necessary to examine the association between concurrent vertical disease programmes on patient outcomes”, said Dr Enegela.
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