Early Versus Late cART Treatment in HIVTB Coinfected Patients in Argentina

1
Early Versus Late cART Treatment in HIV/TB
Co-infected Patients in Argentina

• Background
• For patients co-infected with HIV and
  tuberculosis (TB) the optimal timeline for
  initiating combination antiretroviral therapy
  (cART) while on TB treatment remains
  controversial.
• Objective
• To compare clinical outcomes of HIV/TB infected
  patients initiating cART within 8 weeks (Early)
  or after (Late) 8 weeks of TB treatment
  initiation.
• Methods
• Cohort study design was utilized with data from
  HIV/TB infected patients diagnosed between
  January 1997 through January 2008 and pursuing TB
  treatment. Clinical, demographic, laboratory,
  treatment and outcome data were collected on
  these patients from 12 clinical sites.

2
Results Characteristics
3
ResultsOutcomes

• Limitations
• Bias and confounders time cART available, IRIS,
  adherence, ...etc.
• Conclusions Variables significantly different
  between Early cART vs. Late cART included
  cure/treatment completed, cART treatment and
  concomitant diagnosis, prior TB, previous AIDS
  were significantly different between Early versus
  late cART treatment
• Study groups were not homogeneous therefore
  further investigations are required to clarify
  these findings.

4
Mortality
Etiologies Late group Sepsis 2 TBC 2 not
done1 Early group IRA2 TBC 4 toxoplasmosis
1 cryptococosis 1, Lymphoma 1 HTA 1.
5

• Thanks
• H. Belgrano Claudia Leroux.
• Interzonal A. MDPlata J Corral, M Hualde, C.
  Miglioranza.
• H F.J. Muñiz M Corti, H Metta.
• H. Paroissien E.Warley, N. Tamayo Antabak.
• H. Piñero O. Messina, A. Rodriguez O. Gear.
• H Posadas H. Laplume.
• H Ramos Mejia M. Losso, J. Toibaro, Jose
  Bruguera.
• H Rawson (Córdoba) D. David, C. Marson.
• H San Fernando F. Murano.
• H San Juan de Dios (La plata) J. Contarelli, M.
  Michaan, L. Massera.
• H Santojani E. Bottaro, P. Scapelatto.