Co-trimoxazole preventive therapy (CPT) reduces morbidity and mortality in tuberculosis patients living with HIV – summary of findings and evaluation of the quality of the evidence

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

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

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Annex 3Co-trimoxazole preventive therapy (CPT) reduces morbidity and mortality in tuberculosis patients living with HIV – summary of findings and evaluation of the quality of the evidence

PICO question: Does the administration of routine CPT compared with no CPT reduce the number of illness episodes and deaths in TB patients living with HIV?

Population: TB patients living with HIV

Intervention: CPT

Comparison: no CPT or placebo

Outcomes: mortality, morbidity/hospital admissions/adverse events

1. Outcomes of interest

2. Literature search strategy and information retrieval

3. GRADE profile

4. Risk and benefits assessment

References

1.: Nunn AJ, et al. Role of co-trimoxazole prophylaxis in reducing mortality in HIV infected adults being treated for tuberculosis: randomised clinical trial. BMJ. 2008;337:a257. [PMC free article: PMC2656923] [PubMed: 18617486]
2.: Grimwade K, et al. Effectiveness of cotrimoxazole prophylaxis on mortality in adults with tuberculosis in rural South Africa. AIDS. 2005;19(2):163–168. [PubMed: 15668541]
3.: Zachariah R, et al. Voluntary counselling, HIV testing and adjunctive cotrimoxazole reduces mortality in tuberculosis patients in Thyolo, Malawi. AIDS. 2003;17(7):1053–1061. [PubMed: 12700456]
4.: Wiktor SZ, et al. Efficacy of trimethoprim-sulphamethoxazole prophylaxis to decrease morbidity and mortality in HIV-1-infected patients with tuberculosis in Abidjan, Côte d'Ivoire: a randomised controlled trial. Lancet. 1999;353(9163):1469–1475. [PubMed: 10232312]
5.: Mwaungulu FB, et al. Cotrimoxazole prophylaxis reduces mortality in human immunodeficiency virus-positive tuberculosis patients in Karonga District, Malawi. Bulletin of the World Health Organization. 2004;82(5):354–363. [PMC free article: PMC2622842] [PubMed: 15298226]
6.: Kalou M, et al. Changes in HIV RNA viral load, CD4+ T-cell counts, and levels of immune activation markers associated with anti-tuberculosis therapy and cotrimoxazole prophylaxis among HIV-infected tuberculosis patients in Abidjan, Côte d'Ivoire. Journal of Medical Virology. 2005;75(2):202–208. [PubMed: 15602734]
7.: Chimzizi R, et al. Voluntary counselling, HIV testing and adjunctive cotrimoxazole are associated with improved TB treatment outcomes under routine conditions in Thyolo District, Malawi. International Journal of Tuberculosis and Lung Disease. 2004;8(5):579–585. [PubMed: 15137534]
8.: Atkins D, et al. Grading quality of evidence and strength of recommendations. BMJ. 2004;328(7454):1490. [PMC free article: PMC428525] [PubMed: 15205295]

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WHO Policy on Collaborative TB/HIV Activities: Guidelines for National Programmes and Other Stakeholders. Geneva: World Health Organization; 2012. Annex 3, Co-trimoxazole preventive therapy (CPT) reduces morbidity and mortality in tuberculosis patients living with HIV – summary of findings and evaluation of the quality of the evidence.
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