6 research outputs found
Tuberculosis in antiretroviral treatment programs in lower income countries: availability and use of diagnostics and screening.
In resource-constrained settings, tuberculosis (TB) is a common opportunistic infection and cause of death in HIV-infected persons. TB may be present at the start of antiretroviral therapy (ART), but it is often under-diagnosed. We describe approaches to TB diagnosis and screening of TB in ART programs in low- and middle-income countries
Availability and use of tuberculosis (TB) diagnostics in adult TB patients from 47 ART programs in lower income countries.
<p>The analysis was restricted to patients from sites with access to the diagnostic tools.</p><p>Chi square tests were used to calculate <i>P</i> values.</p
Characteristics of 47 adult ART programs from lower income countries and 987 adult patients seen during the study period in the programs participating in the study.
<p>ART, antiretroviral treatment; TB, tuberculosis; SMS: Short Message Service.</p>1<p>followed-up at time of survey.</p>2<p>proportion of adults with previous history of TB before starting ART.</p
Availability and use of tuberculosis (TB) diagnostics in HIV-infected individuals, comparing sites with a cost model of free services to the patients and all other sites with full payment, cost sharing or any other cost model.
<p>Analysis was restricted to sites which contributed patient data and to patients from sites with access to the diagnostics.</p><p>Chi square tests were used to calculate <i>P</i> values.</p
Program-level characteristics associated with the availability of sputum smear microscopy, culture, chest X-ray, Xpert MTB/RIF, and tuberculin skin testing (TST) in 47 ART programs treating adults in lower income countries.
<p>ART, antiretroviral treatment; TB, tuberculosis; TST, tuberculin skin test.</p><p>Chi square tests were used to calculate <i>P</i> values.</p>1<p>followed-up at time of survey.</p
Characteristics of HIV-2 and HIV-1/HIV-2 Dually Seropositive Adults in West Africa Presenting for Care and Antiretroviral Therapy: The IeDEA-West Africa HIV-2 Cohort Study.
HIV-2 is endemic in West Africa. There is a lack of evidence-based guidelines on the diagnosis, management and antiretroviral therapy (ART) for HIV-2 or HIV-1/HIV-2 dual infections. Because of these issues, we designed a West African collaborative cohort for HIV-2 infection within the framework of the International epidemiological Databases to Evaluate AIDS (IeDEA).We collected data on all HIV-2 and HIV-1/HIV-2 dually seropositive patients (both ARV-naive and starting ART) and followed-up in clinical centres in the IeDEA-WA network including a total of 13 clinics in five countries: Benin, Burkina-Faso Côte d'Ivoire, Mali, and Senegal, in the West Africa region.Data was merged for 1,754 patients (56% female), including 1,021 HIV-2 infected patients (551 on ART) and 733 dually seropositive for both HIV-1 and HIV 2 (463 on ART). At ART initiation, the median age of HIV-2 patients was 45.3 years, IQR: (38.3-51.7) and 42.4 years, IQR (37.0-47.3) for dually seropositive patients (p = 0.048). Overall, 16.7% of HIV-2 patients on ART had an advanced clinical stage (WHO IV or CDC-C). The median CD4 count at the ART initiation is 166 cells/mm(3), IQR (83-247) among HIV-2 infected patients and 146 cells/mm(3), IQR (55-249) among dually seropositive patients. Overall, in ART-treated patients, the CD4 count increased 126 cells/mm(3) after 24 months on ART for HIV-2 patients and 169 cells/mm(3) for dually seropositive patients. Of 551 HIV-2 patients on ART, 5.8% died and 10.2% were lost to follow-up during the median time on ART of 2.4 years, IQR (0.7-4.3).This large multi-country study of HIV-2 and HIV-1/HIV-2 dual infection in West Africa suggests that routine clinical care is less than optimal and that management and treatment of HIV-2 could be further informed by ongoing studies and randomized clinical trials in this population