High rates of tuberculosis in patients accessing HAART in rural South Africa.
| dc.contributor.author | Naidoo, Kogieleum. | |
| dc.contributor.author | Abdool Karim, Quarraisha. | |
| dc.contributor.author | Bhushan, Ambika. | |
| dc.contributor.author | Naidoo, Kasavan. | |
| dc.contributor.author | Yende-Zuma, Fortunate Nonhlanhla. | |
| dc.contributor.author | Mchunu, Patricia K. | |
| dc.contributor.author | Fröhlich, Janet Ann. | |
| dc.contributor.author | Karim, Farina. | |
| dc.contributor.author | Upfold, Michele. | |
| dc.contributor.author | Kocheleff, Paul. | |
| dc.contributor.author | Abdool Karim, Salim Safurdeen. | |
| dc.date.accessioned | 2016-10-25T08:50:59Z | |
| dc.date.available | 2016-10-25T08:50:59Z | |
| dc.date.created | 2014 | |
| dc.date.issued | 2014 | |
| dc.description | CAPRISA, 2014. | en_US |
| dc.description.abstract | Background: The challenge of early tuberculosis (TB) infection among rural patients accessing highly active antiretroviral therapy (HAART) in a resource-limited setting with high HIV and TB burden has not been fully quantified. Methods: This is a retrospective study nested within a prospective study of 969 patients consecutively initiated onto HAART at the CAPRISA AIDS Treatment programme in rural KwaZulu-Natal between January 2007 and December 2010. Patients were screened for clinical symptoms consistent with TB using a standardized checklist, and routine clinical investigations that included sputum microscopy and chest x-ray diagnosis. Results: Of 969 HIV-infected patients initiated on HAART, 173 [17.9%; 95% confidence interval (CI): 15.5 to 20.4] had active TB at HAART initiation. TB incidence rates were 3-fold higher in the first 3 months (early incident TB) after HAART initiation [11.5/100 person years (py); 95% CI: 7.1 to 17.5] compared with 4–24 months (late incident TB) post-HAART initiation (3.2/100 py; 95% CI: 2.2 to 4.5; incidence rate ratio: 3.6; 95% CI: 2.0 to 6.4; P , 0.001). Immune status of patients at HAART initiation did not impact TB incidence rates in patients with CD4+ counts of ,50 (5.3/100) and .200 (4.9/100 py; P = 0.81) cells per cubic millimeter. CD4+ count gains achieved 12 months post-HAART initiation were significantly different in patients with early incident TB versus late incident TB; P = 0.03. Conclusions: Rural HIV treatment programmes in TB-endemic settings experience high rates of TB irrespective of immunologic status of patients at HAART initiation, or duration on HAART. | en_US |
| dc.identifier.citation | Naidoo, K., Karim, Q.A., Bhushan, A., Naidoo, K., Yende-Zuma, N., Mchunu, P.K., Frohlich, J., Karim, F., Upfold, M., Kocheleff, P. and Karim, S.S.A. 2014. High rates of tuberculosis in patients accessing HAART in rural South Africa. Journal of Acquired Immune Deficiency Syndromes 65(4), 438-446. | en_US |
| dc.identifier.uri | http://dx.doi.org/10.1097/QAI.0000000000000060 | en_US |
| dc.identifier.uri | http://hdl.handle.net/10413/13543 | |
| dc.language.iso | en | en_US |
| dc.publisher | Lippincott Williams & Wilkins. | en_US |
| dc.subject | HIV. | en_US |
| dc.subject | Tuberculosis. | en_US |
| dc.subject | HAART. | en_US |
| dc.subject | South Africa. | en_US |
| dc.title | High rates of tuberculosis in patients accessing HAART in rural South Africa. | en_US |
| dc.type | Peer reviewed journal article. | en_US |