Earlier initiation of antiretroviral therapy prevents active tuberculosis in people living with HIV – summary of findings and evaluation of the quality of the evidence

Warning: The NCBI web site requires JavaScript to function. more...

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

WHO Policy on Collaborative TB/HIV Activities: Guidelines for National Programmes and Other Stakeholders. Geneva: World Health Organization; 2012.

Cover of WHO Policy on Collaborative TB/HIV Activities

WHO Policy on Collaborative TB/HIV Activities: Guidelines for National Programmes and Other Stakeholders.

Show details

Contents

< Prev Next >

Annex 1Earlier initiation of antiretroviral therapy prevents active tuberculosis in people living with HIV – summary of findings and evaluation of the quality of the evidence

PICO question: Can earlier initiation of antiretroviral therapy (ART) at higher CD4 counts (>350 cells/mm³) be used to prevent active tuberculosis in people living with HIV? Should antiretroviral therapy be used to prevent active tuberculosis?

Population: adults and adolescents living with HIV

Intervention: ART at CD4 counts >350 cells/mm³

Comparison: no ART or ART deferred until CD4 counts ≤350 cells/mm³

Outcomes: TB incidence rate

1. Outcomes of interest

2. Literature search strategy and information retrieval

3. GRADE profile

4. Risk and benefits assessment

References

1.: Miranda A, et al. Impact of antiretroviral therapy on the incidence of tuberculosis: the Brazilian experience, 1995–2001. PLoS ONE. 2007;2(9):e826. [PMC free article: PMC1952142] [PubMed: 17786198]
2.: Santoro-Lopes G, et al. Reduced risk of tuberculosis among Brazilian patients with advanced human immunodeficiency virus infection treated with highly active antiretroviral therapy. Clinical Infectious Diseases. 2002 Feb 15;34(4):543–6. [PubMed: 11797184]
3.: Girardi E, et al. Impact of combination antiretroviral therapy on the risk of tuberculosis among persons with HIV infection. AIDS. 2000;14(13):1985–1991. [PubMed: 10997404]
4.: Lawn SD, et al. Short-term and long-term risk of tuberculosis associated with CD4 cell recovery during antiretroviral therapy in South Africa. AIDS. 2009;23(13):1717–1725. [PMC free article: PMC3801095] [PubMed: 19461502]
5.: Egger M, editor. Outcomes of ART in resource-limited and industrialized countries. 14th Conference on retroviruses and opportunistic infections (CROI 2007); Los Angeles, USA. CROI.
6.: Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach, 2010 revision. Geneva: World Health Organization; 2010. [PubMed: 23741771]
7.: Badri M, Wilson D, Wood R. Effect of highly active antiretroviral therapy on incidence of tuberculosis in South Africa: a cohort study. Lancet. 2002;359(9323):2059–2064. [PubMed: 12086758]
8.: Del Amo J, Hernan M., (HIV-CASUAL). Combined antiretroviral therapy and the incidence of tuberculosis among HIV-positive individuals in high-income countries. personal communication. 2011.
9.: Severe P, et al. Early versus standard antiretroviral therapy for HIV-infected adults in Haiti. New England Journal of Medicine. 2010;363(3):257–265. [PMC free article: PMC3676927] [PubMed: 20647201]
10.: Cohen MS, et al. Prevention of HIV-1 Infection with Early Antiretroviral Therapy. New England Journal of Medicine. 2011;365(6):493–505. [PMC free article: PMC3200068] [PubMed: 21767103]
11.: Golub JE, et al. The impact of antiretroviral therapy and isoniazid preventive therapy on tuberculosis incidence in HIV-infected patients in Rio de Janeiro, Brazil. AIDS. 2007;21(11):1441–1418. [PMC free article: PMC3063947] [PubMed: 17589190]
12.: Golub JE, et al. Isoniazid preventive therapy, HAART and tuberculosis risk in HIV-infected adults in South Africa: a prospective cohort. AIDS. 2009;23(5):631–636. [PMC free article: PMC3063949] [PubMed: 19525621]
13.: Girardi E, et al. Incidence of Tuberculosis among HIV-infected patients receiving highly active antiretroviral therapy in Europe and North America. Clinical Infectious Diseases. 2005;41(12):1772–1782. [PubMed: 16288403]
14.: Jones JL, et al. HIV-associated tuberculosis in the era of highly active antiretroviral therapy. The Adult/Adolescent Spectrum of HIV Disease Group. International Journal of Tuberculosis and Lung Disease. 2000;4(11):1026–1031. [PubMed: 11092714]
15.: Lau B, Zhang J., (NA-ACCORD). Incidence of Tuberculosis after HAART Initiation in HIV-infected persons. personal communication. 2011.
16.: Ledergerber B, et al. AIDS-related opportunistic illnesses occurring after initiation of potent antiretroviral therapy: the Swiss HIV Cohort Study. JAMA. 1999;282(23):2220–2226. [PubMed: 10605973]
17.: Moreno S, et al. Incidence and risk factors for tuberculosis in HIV-positive subjects by HAART status. International Journal of Tuberculosis and Lung Disease. 2008;12(12):1393–1400. [PubMed: 19017448]

All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: tni.ohw@sredrokoob).

Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press through the WHO web site (http://www.who.int/about/licensing/copyright_form/en/index.html).

Bookshelf ID: NBK131885

Contents

< Prev Next >

PubReader
Print View
Cite this Page
WHO Policy on Collaborative TB/HIV Activities: Guidelines for National Programmes and Other Stakeholders. Geneva: World Health Organization; 2012. Annex 1, Earlier initiation of antiretroviral therapy prevents active tuberculosis in people living with HIV – summary of findings and evaluation of the quality of the evidence.
PDF version of this title (1.3M)