Does Cotrimoxazole Prophylaxis Improve Outcomes after ART Initiation in HIV-infected African Adults? A Causal Analysis Using Marginal Structural Models.
In a study of HIV-infected patients in Uganda and Zimbabwe, who were receiving antiretroviral therapy (ART), cotrimoxazole prophylaxis was prescribed at the treating physician's discretion. Marginal structural models were applied to this observational data, where cotrimoxazole prophylaxis was not used continuously and depended on time-varying confounders; they suggested that current prophylaxis rediced the risk of mortality and malaria, but not WHO 4 events, in patients receiving ART. The benefits appeared to be greater in the first 12 weeks.
15th Conference on Retroviruses and Opportunistic Infections, Boston, USA, 5-8 February 2008: Abstract 846b.