Effectiveness of early initiation of antiretroviral therapy in adults with HIV associated tuberculosis in Lesotho in 2012. Issue 3 (25th August 2017)

• Record Type: Journal Article
• Authors: Lenela, Maletsatsi; Knight, Stephen
• Is Part Of: Southern African journal of infectious diseases. Volume 32:Issue 3(2017)
• Page Start: 87
• Page End: 90
• Publication Date: 2017-08-25
• Subjects: low income country -- tuberculosis treatment; Epidemiology -- Periodicals; Communicable diseases -- Periodicals; Sexually transmitted diseases -- Periodicals; 616.905
• DOI: 10.1080/23120053.2017.1302701
• Languages: English
• ISSNs: 2312-0053

Abstract

Abstract : Background: Lesotho has a huge burden of human immunodeficiency virus associated tuberculosis (HIV-TB). In this study we compared the effectiveness of early versus late commencement of antiretroviral therapy (ART) in adults living with HIV-TB in Lesotho. Methods: Three out of 17 hospitals were randomly selected and data extracted from the hospitals' tuberculosis (TB) treatment registers for 247 adults living with HIV-TB who completed TB therapy during the first quarter of 2012. Results: Eighty (32%) commenced ART early (<4 weeks), 100 (41%) were started late (≥4 weeks) and 67 (27%) received no ART. Both early and late ART initiators were more likely to have a successful TB outcome (Adjusted Odds Ratio (AOR) 10.1, 95% CI: 3.7 - 27.5 and AOR 8.4, 95% CI: 3.4 - 20.6, respectively) relative to the group who had no ART ( p < 0.001). Conclusions: Effective treatment exists for managing HIV-TB simultaneously. The guidelines for initiation of ART in adult HIV-TB in Lesotho have not been fully implemented, but those who commenced ART had significant clinical benefits. Health departments must address the challenges encountered in treating HIV-TB simultaneously to ensure those co-infected receive optimal care.