@article {Zachariah:2007:1027-3719:848,
title = "Does antiretroviral treatment reduce case fatality among HIV-positive patients with tuberculosis in Malawi?",
journal = "The International Journal of Tuberculosis and Lung Disease",
parent_itemid = "infobike://iuatld/ijtld",
publishercode ="iuatld",
year = "2007",
volume = "11",
number = "8",
publication date ="2007-08-01T00:00:00",
pages = "848-853",
itemtype = "ARTICLE",
issn = "1027-3719",
eissn = "1815-7920",
url = "https://www.ingentaconnect.com/content/iuatld/ijtld/2007/00000011/00000008/art00004",
keyword = "case fatality, TB, Malawi, HIV/AIDS, ART",
author = "Zachariah, R. and Fitzgerald, M. and Massaquoi, M. and Acabu, A. and Chilomo, D. and Salaniponi, F. M. L. and Harries, A. D.",
abstract = "SETTING: Thyolo district, Malawi.OBJECTIVES: To report on 1) case fatality among human immunodeficiency virus (HIV) positive tuberculosis (TB) patients while on anti-tuberculosis treatment and 2) whether antiretroviral treatment (ART) initiated during the continuation phase of TB treatment reduces case fatality.DESIGN: Retrospective cohort analysis.METHODS: Comparative analysis of treatment outcomes for TB patients registered between January and December 2004.RESULTS: Of 983 newly registered TB patients receiving diagnostic HIV testing, 658 (67%) were HIV-positive. A total of 132 (20%) patients died during the 8-month course of anti-tuberculosis treatment, of whom 82 (62%) died within the first 2 months of treatment when ART was not provided (cumulative incidence 3.0, 95%CI 2.53.6 per 100 person-years). A total of 576 TB patients started the continuation phase of anti-tuberculosis treatment, 180 (31%) of whom were started on ART. The case-fatality rate per 100 person-years was not significantly different for patients on ART (1.0, 95%CI 0.61.7) and those without ART (1.2, 95%CI 0.91.7, adjusted hazard ratio 0.86, 95%CI 0.41.6, P = 0.6)CONCLUSIONS: ART provided in the continuation phase of TB treatment does not have a significant impact on reducing case fatality. Reasons for this and possible measures to reduce high case fatality in the initial phase of TB treatment are discussed.",
}