Early versus delayed initiation of highly active antiretroviral therapy for HIV-positive adults with newly diagnosed pulmonary tuberculosis (TB-HAART): a prospective, international, randomised, placebo-controlled trial

by Sayoki G Mfinanga, Bruce J Kirenga, Duncan M Chanda et al.
The Lancet Infectious Diseases, Early Online Publication, 6 May 2014

9 pp. 222 kB:
http://download.thelancet.com/pdfs/journals/laninf/PIIS1473309914707339.pdfS1473309914X70696_cov150h

WHO guidelines recommend early initiation of antiretroviral therapy (ART) irrespective of CD4 cell count for all patients with tuberculosis who also have HIV, but evidence supporting this approach is poor quality. From this study the authors conclude that ART can be delayed until after completion of 6 months of tuberculosis treatment for HIV-positive patients with tuberculosis who have CD4 cell counts greater than 220 cells per μL. WHO guidelines should be updated accordingly.

 

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