Impact of combination antiretroviral therapy initiation on adherence to antituberculosis treatment

Southern African Journal of HIV Medicine

 
 
Field Value
 
Title Impact of combination antiretroviral therapy initiation on adherence to antituberculosis treatment
 
Creator Knight, Marlene van Zyl, Robyn L. Sanne, Ian Bassett, Jean van Rie, Annelies
 
Subject Medicine; Health Sciences; Infectious Diseases; Public Health MEMS; pill count; HIV, sub-Saharan Africa, tuberculosis
Description Background: Healthcare workers are often reluctant to start combination antiretroviral therapy (ART) in patients receiving tuberculosis (TB) treatment because of the fear of high pill burden, immune reconstitution inflammatory syndrome, and side-effects.Object: To quantify changes in adherence to tuberculosis treatment following ART initiation.Design: A prospective observational cohort study of ART-naïve individuals with baseline CD4 count between 50 cells/mm3 and 350 cells/mm3 at start of TB treatment at a primary care clinic in Johannesburg, South Africa. Adherence to TB treatment was measured by pill count,self-report, and electronic Medication Event Monitoring System (eMEMS) before and after initiation of ART.Results: ART tended to negatively affect adherence to TB treatment, with an 8% – 10% decrease in the proportion of patients adherent according to pill count and an 18% – 22% decrease in the proportion of patients adherent according to eMEMS in the first month following ART initiation, independent of the cut-off used to define adherence (90%, 95% or 100%). Reasons for non-adherence were multi factorial, and employment was the only predictor for optimal adherence (adjusted odds ratio 4.11, 95% confidence interval 1.06–16.0).Conclusion: Adherence support in the period immediately following ART initiation could optimise treatment outcomes for people living with TB and HIV.
 
Publisher AOSIS
 
Contributor PEPFAR National Institutes of Health grant UM1 AI069463, the United States Agency for International Development grants to Right to Care: 674-A-00-08-00007 and 674-A-12-00020 the University of the Witwatersrand Faculty of Health Sciences Research
Date 2015-10-08
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Prospective observational cohort study
Format text/html application/octet-stream text/xml application/pdf
Identifier 10.4102/sajhivmed.v16i1.346
 
Source Southern African Journal of HIV Medicine; Vol 16, No 1 (2015); 6 pages 2078-6751 1608-9693
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://sajhivmed.org.za/index.php/hivmed/article/view/346/582 https://sajhivmed.org.za/index.php/hivmed/article/view/346/583 https://sajhivmed.org.za/index.php/hivmed/article/view/346/584 https://sajhivmed.org.za/index.php/hivmed/article/view/346/569
 
Coverage South Africa — —
Rights Copyright (c) 2015 Marlene Knight, Robyn L. van Zyl, Ian Sanne, Jean Bassett, Annelies van Rie https://creativecommons.org/licenses/by/4.0
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