@article {Padayatchi:2014:1027-3719:147,
title = "Improved survival in multidrug-resistant tuberculosis patients receiving integrated tuberculosis and antiretroviral treatment in the SAPiT Trial",
journal = "The International Journal of Tuberculosis and Lung Disease",
parent_itemid = "infobike://iuatld/ijtld",
publishercode ="iuatld",
year = "2014",
volume = "18",
number = "2",
publication date ="2014-02-01T00:00:00",
pages = "147-154",
itemtype = "ARTICLE",
issn = "1027-3719",
eissn = "1815-7920",
url = "https://www.ingentaconnect.com/content/iuatld/ijtld/2014/00000018/00000002/art00005",
doi = "doi:10.5588/ijtld.13.0627",
keyword = "MDR-TB, HIV treatment",
author = "Padayatchi, N. and Abdool Karim, S. S. and Naidoo, K. and Grobler, A. and Friedland, G.",
abstract = "BACKGROUND: The therapeutic effects of antiretroviral treatment (ART) in patients with multidrug-resistant tuberculosis (MDR-TB) and human immunodeficiency virus (HIV) infection have not been established.OBJECTIVE: To assess therapeutic outcomes of integrating ART with treatment
for MDR-TB.DESIGN: A subgroup of MDR-TB patients from a randomised controlled trial, the SAPiT (Starting Antiretroviral Therapy at Three Points in Tuberculosis) study, conducted in an out-patient clinic in Durban, South Africa, from 2008 to 2012.METHODS: Clinical outcomes at 18 months
were compared in patients randomised to receive ART within 12 weeks of initiating standard first-line anti-tuberculosis treatment with those who commenced ART after completing anti-tuberculosis treatment.RESULTS: Mycobacterium tuberculosis drug susceptibility results were available
in 489 (76%) of 642 SAPiT patients: 23 had MDR-TB, 14 in the integrated treatment arm and 9 in the sequential treatment arm. At 18 months, the mortality rate was 11.9/100 person-years (py; 95%CI 1.442.8) in the combined integrated treatment arm and 56.0/100 py (95%CI 18.2130.8)
in the sequential treatment arm (hazard ratio adjusted for baseline CD4 count and whether MDR-TB treatment was initiated: 0.14; 95%CI 0.020.94, P = 0.04).CONCLUSION: Despite the small sample size, the 86% reduction in mortality due to early initiation of ART in MDR-TB patients
was statistically significant.",
}