Cotrimoxazole prophylaxis decreases tuberculosis risk among Asian patients with HIV. Issue 3 (29th March 2019)

• Record Type: Journal Article
• Authors: Ku, Stephane Wen‐Wei; Jiamsakul, Awachana; Joshi, Kedar; Pasayan, Mark Kristoffer Ungos; Widhani, Alvina; Chaiwarith, Romanee; Kiertiburanakul, Sasisopin; Avihingsanon, Anchalee; Ly, Penh Sun; Kumarasamy, Nagalingeswaran; Do, Cuong D; Merati, Tuti P; Nguyen, Kinh Van; Kamarulzaman, Adeeba; Zhang, Fujie; Lee, Man Po; Choi, Jun Yong; Tanuma, Junko; Khusuwan, Suwimon; Sim, Benedict Lim Heng; Ng, Oon Tek; Ratanasuwan, Winai; Ross, Jeremy; Wong, Wing‐Wai
• Other Names: Ly PS investigator.; Khol V investigator.; Zhang FJ investigator.; Zhao HX investigator.; Han N investigator.; Lee MP investigator.; Li PCK investigator.; Lam W investigator.; Chan YT investigator.; Kumarasamy N investigator.; Saghayam S investigator.; Ezhilarasi C investigator.; Pujari S investigator.; Joshi K investigator.; Gaikwad S investigator.; Chitalikar A investigator.; Sangle S investigator.; Mave V investigator.; Marbaniang I investigator.; Wirawan DN investigator.; Yuliana F investigator.; Yunihastuti E investigator.; Imran D investigator.; Widhani A investigator.; Tanuma J investigator.; Oka S investigator.; Nishijima T investigator.; Choi JY investigator.; S Na investigator.; Kim JM investigator.; Sim BLH investigator.; Gani YM investigator.; Rudi NB investigator.; Kamarulzaman A investigator.; Syed Omar SF investigator.; Ponnampalavanar S investigator.; Azwa I investigator.; Ditangco R investigator.; Pasayan MK investigator.; Mationg ML investigator.; Wong WW investigator.; Ku SWW investigator.; Wu PC investigator.; Ng OT investigator.; Lim PL investigator.; Lee LS investigator.; Ferdous Z investigator.; vihingsanon A investigator.; Gatechompol S investigator.; Phanuphak P investigator.; Phadungphon C investigator.; Kiertiburanakul S investigator.; Phuphuakrat A investigator.; Chumla L investigator.; Sanmeema N investigator.; Chaiwarith R investigator.; Sirisanthana T investigator.; Kotarathititum W investigator.; Praparattanapan J investigator.; Khusuwan S investigator.; Kantipong P investigator.; Kambua P investigator.; Ratanasuwan W investigator.; Sriondee R investigator.; Nguyen KV investigator.; Bui HV investigator.; Nguyen DTH investigator.; Nguyen DT investigator.; Do CD investigator.; Ngo AV investigator.; Nguyen LT investigator.; Sohn AH investigator.; Ross JL investigator.; Petersen B investigator.; Cooper DA investigator.; Law MG investigator.; Jiamsakul A investigator.; Rupasinghe D investigator.;
• Is Part Of: Journal of the International AIDS Society. Volume 22:Issue 3(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-03-29
• Subjects: cotrimoxazole -- sulphamethoxazole/trimethoprim -- tuberculosis -- HIV -- AIDS -- Asia -- cohort studies -- prophylaxis; AIDS (Disease) -- Periodicals; HIV infections -- Periodicals; 616.9792005
• DOI: 10.1002/jia2.25264
• Languages: English
• ISSNs: 1758-2652

Abstract

Abstract: Introduction: Cotrimoxazole (CTX) is recommended as prophylaxis against Pneumocystis jiroveci pneumonia, malaria and other serious bacterial infections in HIV‐infected patients. Despite its in vitro activity against Mycobacterium tuberculosis, the effects of CTX preventive therapy on tuberculosis (TB) remain unclear. Methods: Adults living with HIV enrolled in a regional observational cohort in Asia who had initiated combination antiretroviral therapy (cART) were included in the analysis. Factors associated with new TB diagnoses after cohort entry and survival after cART initiation were analysed using Cox regression, stratified by site. Results: A total of 7355 patients from 12 countries enrolled into the cohort between 2003 and 2016 were included in the study. There were 368 reported cases of TB after cohort entry with an incidence rate of 0.99 per 100 person‐years (/100 pys). Multivariate analyses adjusted for viral load (VL), CD4 count, body mass index (BMI) and cART duration showed that CTX reduced the hazard for new TB infection by 28% (HR 0.72, 95% CI l 0.56, 0.93). Mortality after cART initiation was 0.85/100 pys, with a median follow‐up time of 4.63 years. Predictors of survival included age, female sex, hepatitis C co‐infection, TB diagnosis, HIV VL, CD4 count and BMI. Conclusions: CTX was associated with a reduction in the hazard for new TB infection but did not impact survival in our Asian cohort. The potential preventive effect of CTX against TB during periods of severe immunosuppression should be further explored.