Mycobacterium tuberculosis Microbiologic and Clinical Treatment Outcomes in a Randomized Trial of Immediate versus CD4+-Initiated Antiretroviral Therapy in HIV-Infected Adults with a High CD4+ Cell Count

• Published in: Clinical infectious diseases 2010-08, Vol.51 (3), p.359-362
• Main Authors: Chamie, Gabriel, Charlebois, Edwin D., Srikantiah, Padmini, Walusimbi-Nanteza, Maria, Mugerwa, Roy D., Mayanja, Harriet, Okwera, Alphonse, Whalen, Christopher C., Havlir, Diane V.
• Format: Article
• Language: English
• Subjects: Adult; Anti-HIV Agents - administration & dosage; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiretroviral drugs; antiretroviral therapy; Antiretroviral Therapy, Highly Active - methods; Antiretrovirals; Antitubercular Agents - administration & dosage; Antiviral agents; Art therapy; Arts; Bacteria; Biological and medical sciences; CD4 antigen; CD4 Lymphocyte Count; Cell culture; Cells; Clinical trials; Comparative analysis; Female; HIV; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - immunology; HIV/AIDS; Human immunodeficiency virus; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Lung - pathology; Male; Medical sciences; Mycobacterium tuberculosis; Mycobacterium tuberculosis - isolation & purification; Pharmacology. Drug treatments; Pleural tuberculosis; Prospective Studies; Pulmonary tuberculosis; Radiography; Radiography, Thoracic; Sputum; Sputum - microbiology; T lymphocytes; Treatment Outcome; Tuberculosis; Tuberculosis - drug therapy; Tuberculosis - microbiology; Tuberculosis - pathology; Uganda; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/654799

In a prospective randomized, controlled trial in Uganda comparing the efficacy of antiretroviral therapy during tuberculosis therapy with the efficacy of tuberculosis therapy alone in HIV-infected patients with tuberculosis who have a CD4+ cell count >350 cells/µL, it was found that antiretroviral therapy did not accelerate microbiologic, radiographic, or clinical responses to tuberculosis therapy: 18% of participants had sputum smears positive for Mycobacterium tuberculosis after 5 months of tuberculosis therapy, despite having had negative culture results. Trial registration. ClinicalTrials.gov identifier: NCT00078247.