The setting for this study was all public health facilities in two
provinces of Zimbabwe. It was a retrospective cohort study.
The objective was to determine, among tuberculosis (TB) patients with
human immunodeficiency virus (HIV) registered in 2010, 1. the proportion
started on antiretroviral treatment (ART), 2. the timing of ART in
relation to the start of anti-tuberculosis treatment, and 3. whether
timing of ART influenced anti-tuberculosis treatment outcomes.
Of the 2655 HIV-positive TB patients, 1115 (42%) were documented as
receiving ART. Of these, 178 (16%) started ART prior to
anti-tuberculosis treatment. Of those who started after
anti-tuberculosis treatment, 17% started within 2 weeks, 43% between 2
and 8 weeks and 40% after 8 weeks. Treatment success in the cohort was
82%, with 14% deaths before completion of anti-tuberculosis treatment.
Not receiving ART during anti-tuberculosis treatment was associated with
lower anti-tuberculosis treatment success (adjusted RR 0.70, 95%CI
0.53-0.91) and more deaths (adjusted RR 3.43, 95%CI 2.2-5.36). There
were no differences in TB treatment outcomes by timing of ART
It was concluded that ART uptake is low given the improved treatment
outcomes in those put on ART during anti-tuberculosis treatment. Better
integration of HIV and TB services is needed to ensure increased
coverage and earlier ART uptake.
Takarinda, KC.; Harries, AD.; Mutasa-Apollo, T.; Sandy, C.; Murimwa, T.; Mugurungi, O. ART uptake, its timing and relation to anti-tuberculosis treatment outcomes among HIV-infected TB patients. Public Health Action (2012) 2 (3) 50-55. [DOI: 10.5588/pha.12.0011]
ART uptake, its timing and relation to anti-tuberculosis treatment outcomes among HIV-infected TB patients.