Journal
AIDS RESEARCH AND HUMAN RETROVIRUSES
Volume 25, Issue 12, Pages 1277-1285Publisher
MARY ANN LIEBERT, INC
DOI: 10.1089/aid.2009.0100
Keywords
-
Categories
Funding
- GlaxoSmithKline
Ask authors/readers for more resources
Fixed dose combination abacavir/lamivudine/zidovudine (ABC/3TC/ZDV) among HIV-1 and tuberculosis (TB)-coinfected patients was evaluated and outcomes between early vs. delayed initiation were compared. In a randomized, pilot study conducted in the Kilimanjaro Region of Tanzania, HIV-infected inpatients with smear-positive TB and total lymphocyte count < 1200/mm(3) were randomized to initiate ABC/3TC/ZDV either 2 (early) or 8 (delayed) weeks after commencing antituberculosis therapy and were followed for 104 weeks. Of 94 patients screened, 70 enrolled (41% female, median CD4 count 103 cells/mm(3)), and 33 in each group completed 104 weeks. Two deaths and 12 serious adverse events (SAEs) were observed in the early arm vs. one death, one clinical failure, and seven SAEs in the delayed arm (p=0.6012 for time to first grade 3/4 event, SAE, or death). CD4 cell increases were +331 and +328 cells/mm(3), respectively. TB-immune reconstitution inflammatory syndromes (TB-IRIS) were not observed in any subject. Using intent-to-treat (ITT), missing failure analyses, 74% (26/35) vs. 89% (31/35) randomized to early vs. delayed therapy had HIV RNA levels < 400 copies/ml at 104 weeks (p=0.2182) and 66% (23/35) vs. 74% (26/35), respectively, had HIV RNA levels < 50 copies/ml (p =0.6026). In an analysis in which switches from ABC/3TC/ZDV failure, those receiving early therapy were less likely to be suppressed to < 400 copies/ml [60% (21/35) vs. 86% (30/35), p=0.030]. TB-IRIS was not observed among the 70 coinfected subjects beginning antiretroviral treatment. ABC/3TC/ZDV was well tolerated and resulted in steady immunologic improvement. Rates of virologic suppression were similar between early and delayed treatment strategies with triple nucleoside regimens when substitutions were allowed.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available