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4th International AIDS Society Conference on HIV Pathogenesis and TreatmentSydney, Australia - July 22 - 25, 2007 |
TB CO-INFECTION TREATED AT ONSET OF THERAPY DOES NOT AFFECT LONG-TERM RISK OF TREATMENT FAILURE AMONG HIV-1 PATIENTS INITIATING EFAVIRENZ (EFV)-BASED COMBINATION ANTIRETROVIRAL TREATMENT (cART)
IAS Conf HIV Pathog Treat 2007 Jul 22-25;4th: Abstract No. MOAB103
Patel K.1, Patel A.1, Naik E.2, Ranjan R.1, Patel J.3, Tash K.4, Sinnott J.5
1Infectious Diseases Clinic, Ahmedabad, India, 2University of South Florida, Tempa, Florida, United States, 3Adit Molecular Diagnostics, Ahmedabad, India, 4Harvard University, Boston, United States, 5University of South Florida, Infectious Diseases, Tempa, Florida, United States
OBJECTIVES: We previously reported that HIV/TB co-infection can be treated by co-administration of rifampicin and an EFV-based cART regimen without compromising antiviral efficacy. However, it is possible that rifampicin coadministration at the onset of cART has negative implications for long-term prognosis. Through an extended followup from previous cohort we examined whether a prior TB treatment predicts an increased risk of treatment failure.
STUDY DESIGN: A prospective, longitudinal cohort study of HIV-1-infected, naïve patients initiating EFV (600mg)-based cART. Patients with minimum of 12 months follow-up were included in analysis. Patients with tuberculosis received 9 months of rifampicin-containing anti-TB treatment with EFV-based cART, while those without tuberculosis received EFV-based cART alone, after 9 months all patients received EFV-based cART alone. Clinical evaluation occurred monthly, and CD4 cell counts were performed every 3 months.
RESULTS: At the onset of therapy, 195 patients were TB coinfected, while 188 were not. Baseline median CD4 count (90 versus 126) and weight were lower among TB coinfected patients (p=0.002 & p<0.0001, respectively). Comparable improvement in CD4 count was observed in patients with and without TB co-infection at each time point up to 3 years of follow-up.
[Figure 1: Median rise in CD4 in TB and non TB Group.]
The rate of irregular follow-up and those lost/died were similar in the two groups (p=0.33). Immunologic failure was observed in 12.3% and 11.2% patients with and without TB (p=0.72) respectively.
CONCLUSIONS: After up to three years of follow-up, a history of TB co-infection treated with rifampicin did not predict an increased risk of treatment failure among HIV-infected patients on EFV-based cART.
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2007-07-22
MOAB103
TB / HIV: Still a Deadly Partnership
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