Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa

 

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dc.contributor.author Pepper, Dominique J en_ZA
dc.contributor.author Marais, Suzaan en_ZA
dc.contributor.author Wilkinson, Robert J en_ZA
dc.contributor.author Bhaijee, Feriyl en_ZA
dc.contributor.author De Azevedo, Virginia en_ZA
dc.contributor.author Meintjes, Graeme en_ZA
dc.date.accessioned 2015-12-28T06:47:46Z
dc.date.available 2015-12-28T06:47:46Z
dc.date.issued 2011 en_ZA
dc.identifier.citation Pepper, D. J., Marais, S., Wilkinson, R. J., Bhaijee, F., De Azevedo, V., & Meintjes, G. (2011). Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa. PLoS ONE, 6(5), e19484. doi:10.1371/journal.pone.0019484 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/16050
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0019484
dc.description.abstract BACKGROUND: In the developing world, the principal cause of death among HIV-infected patients is tuberculosis (TB). The initiation of antiretroviral therapy (ART) during TB therapy significantly improves survival, however it is not known which barriers prevent eligible TB patients from initiating life-saving ART. Method Setting. A South African township clinic with integrated tuberculosis and HIV services. Design. Logistic regression analyses of a prospective cohort of HIV-1 infected adults (≥18 years) who commenced TB therapy, were eligible for ART, and were followed for 6 months. FINDINGS: Of 100 HIV-1 infected adults eligible for ART during TB therapy, 90 TB patients presented to an ART clinic for assessment, 66 TB patients initiated ART, and 15 TB patients died. 34% of eligible TB patients (95%CI: 25-43%) did not initiate ART. Male gender and younger age (<36 years) were associated with failure to initiate ART (adjusted odds ratios of 3.7 [95%CI: 1.25-10.95] and 3.3 [95%CI: 1.12-9.69], respectively). Death during TB therapy was associated with a CD4+ count <100 cells/µL. CONCLUSION: In a clinic with integrated services for tuberculosis and HIV, one-third of eligible TB patients - particularly young men - did not initiate ART. Strategies are needed to promote ART initiation during TB therapy, especially among young men. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other Tuberculosis en_ZA
dc.subject.other Antiretroviral therapy en_ZA
dc.subject.other Tuberculosis diagnosis and management en_ZA
dc.subject.other Mycobacterium tuberculosis en_ZA
dc.subject.other History of tuberculosis en_ZA
dc.subject.other HIV diagnosis and management en_ZA
dc.subject.other Drug screening en_ZA
dc.subject.other Hospitals en_ZA
dc.title Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2011 Pepper et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Institute of Infectious Disease and Molecular Medicine en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Pepper, D. J., Marais, S., Wilkinson, R. J., Bhaijee, F., De Azevedo, V., & Meintjes, G. (2011). Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa. <i>PLoS One</i>, http://hdl.handle.net/11427/16050 en_ZA
dc.identifier.chicagocitation Pepper, Dominique J, Suzaan Marais, Robert J Wilkinson, Feriyl Bhaijee, Virginia De Azevedo, and Graeme Meintjes "Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa." <i>PLoS One</i> (2011) http://hdl.handle.net/11427/16050 en_ZA
dc.identifier.vancouvercitation Pepper DJ, Marais S, Wilkinson RJ, Bhaijee F, De Azevedo V, Meintjes G. Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa. PLoS One. 2011; http://hdl.handle.net/11427/16050. en_ZA
dc.identifier.ris TY - Journal Article AU - Pepper, Dominique J AU - Marais, Suzaan AU - Wilkinson, Robert J AU - Bhaijee, Feriyl AU - De Azevedo, Virginia AU - Meintjes, Graeme AB - BACKGROUND: In the developing world, the principal cause of death among HIV-infected patients is tuberculosis (TB). The initiation of antiretroviral therapy (ART) during TB therapy significantly improves survival, however it is not known which barriers prevent eligible TB patients from initiating life-saving ART. Method Setting. A South African township clinic with integrated tuberculosis and HIV services. Design. Logistic regression analyses of a prospective cohort of HIV-1 infected adults (≥18 years) who commenced TB therapy, were eligible for ART, and were followed for 6 months. FINDINGS: Of 100 HIV-1 infected adults eligible for ART during TB therapy, 90 TB patients presented to an ART clinic for assessment, 66 TB patients initiated ART, and 15 TB patients died. 34% of eligible TB patients (95%CI: 25-43%) did not initiate ART. Male gender and younger age (<36 years) were associated with failure to initiate ART (adjusted odds ratios of 3.7 [95%CI: 1.25-10.95] and 3.3 [95%CI: 1.12-9.69], respectively). Death during TB therapy was associated with a CD4+ count <100 cells/µL. CONCLUSION: In a clinic with integrated services for tuberculosis and HIV, one-third of eligible TB patients - particularly young men - did not initiate ART. Strategies are needed to promote ART initiation during TB therapy, especially among young men. DA - 2011 DB - OpenUCT DO - 10.1371/journal.pone.0019484 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2011 T1 - Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa TI - Barriers to initiation of antiretrovirals during antituberculosis therapy in Africa UR - http://hdl.handle.net/11427/16050 ER - en_ZA


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