scholarly journals Projected population-wide impact of antiretroviral therapy-linked isoniazid preventive therapy in a high-burden setting

AIDS ◽  
2019 ◽  
Vol 33 (3) ◽  
pp. 525-536 ◽  
Author(s):  
Emily A. Kendall ◽  
Andrew S. Azman ◽  
Gary Maartens ◽  
Andrew Boulle ◽  
Robert J. Wilkinson ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
High Burden

TB and HIV/AIDS

2015 ◽  
Author(s):  
Christopher Dye
Keyword(s):  
Public Health ◽  
Risk Factor ◽  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Population Biology ◽  
Preventive Therapy ◽  
Control Measures ◽  
Isoniazid Preventive Therapy ◽  
Global Epidemiology ◽  
Hiv Aids

This chapter examines the dual epidemic of tuberculosis and HIV/AIDS. There have been some major successes in the control of both HIV/AIDS and TB. The discovery and widespread use of antiretroviral therapy (ART) is among the greatest advances in public health during the past thirty years. The rise of TB cases in Africa and elsewhere and on the discovery and implementation of control measures raise a series of questions about the population biology of TB linked to HIV/AIDS. The chapter first provides an overview of HIV infection as a risk factor for TB before discussing the global epidemiology of TB linked to HIV/AIDS. It then describes the anatomy of a TB-HIV epidemic, along with TB control in the presence of HIV. In particular, it considers ART and isoniazid preventive therapy. The chapter concludes with the argument that the DOTS strategy is necessary but not sufficient for TB–HIV control.

scholarly journals Trend analysis of tuberculosis case notifications with scale-up of antiretroviral therapy and roll-out of isoniazid preventive therapy in Zimbabwe, 2000–2018

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e034721
Author(s):  
Kudakwashe C Takarinda ◽  
Anthony D Harries ◽  
Tsitsi Mutasa-Apollo ◽  
Charles Sandy ◽  
Regis C Choto ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Scale Up ◽  
Population Level ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
People Living With Hiv ◽  
National Data ◽  
Tuberculosis Case ◽  
Case Notification ◽  
Roll Out

ObjectivesAntiretroviral therapy (ART) and isoniazid preventive therapy (IPT) are known to have a tuberculosis (TB) protective effect at the individual level among people living with HIV (PLHIV). In Zimbabwe where TB is driven by HIV infection, we have assessed whether there is a population-level association between IPT and ART scale-up and annual TB case notification rates (CNRs) from 2000 to 2018.DesignEcological study using aggregate national data.SettingAnnual aggregate national data on TB case notification rates (stratified by TB category and type of disease), numbers (and proportions) of PLHIV in ART care and of these, numbers (and proportions) ever commenced on IPT.ResultsART coverage in the public sector increased from <1% (8400 PLHIV) in 2004 to ~88% (>1.1 million PLHIV patients) by December 2018, while IPT coverage among PLHIV in ART care increased from <1% (98 PLHIV) in 2012 to ~33% (373 917 PLHIV) by December 2018. These HIV-related interventions were associated with significant declines in TB CNRs: between the highest CNR prior to national roll-out of ART (in 2004) to the lowest recorded CNR after national IPT roll-out from 2012, these were (1) for all TB case (510 to 173 cases/100 000 population; 66% decline, p<0.001); (2) for those with new TB (501 to 159 cases/100 000 population; 68% decline, p<0.001) and (3) for those with new clinically diagnosed PTB (284 to 63 cases/100 000 population; 77.8% decline, p<0.001).ConclusionsThis study shows the population-level impact of the continued scale-up of ART among PLHIV and the national roll-out of IPT among those in ART care in reducing TB, particularly clinically diagnosed TB which is largely associated with HIV. There are further opportunities for continued mitigation of TB with increasing coverage of ART and in particular IPT which still has a low coverage.

scholarly journals Safety and Effectiveness of Isoniazid Preventive Therapy in Pregnant Women Living with Human Immunodeficiency Virus on Antiretroviral Therapy: An Observational Study Using Linked Population Data

2020 ◽  
Vol 71 (8) ◽  
pp. e351-e358 ◽  
Author(s):  
Emma Kalk ◽  
Alexa Heekes ◽  
Ushma Mehta ◽  
Renee de Waal ◽  
Nisha Jacob ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Absolute Risk ◽  
First Trimester ◽  
Preventive Therapy ◽  
Cd4 Count ◽  
Isoniazid Preventive Therapy ◽  
Immunodeficiency Virus

Abstract Background Isoniazid preventive therapy (IPT) is widely used to protect against tuberculosis (TB) in people living with human immunodeficiency virus (HIV). Data on the safety and efficacy of IPT in pregnant women living with HIV (PWLHIV) are mixed. We used an individual-level, population-wide health database to examine associations between antenatal IPT exposure and adverse pregnancy outcomes, maternal TB, all-cause mortality, and liver injury during pregnancy through 12 months postpartum. Methods We used linked routine electronic health data generated in the public sector of the Western Cape, South Africa, to define a cohort of PWLHIV on antiretroviral therapy. Pregnancy outcomes were assessed using logistic regression; for maternal outcomes we applied a proportional hazards model with time-updated IPT exposure. Results Of 43 971 PWLHIV, 16.6% received IPT. Women who received IPT were less likely to experience poor pregnancy outcomes (adjusted odds ratio [aOR], 0.83 [95% confidence interval {CI}, .78–.87]); this association strengthened with IPT started after the first trimester compared with none (aOR, 0.71 [95% CI, .65–.79]) or with first-trimester exposure (aOR, 0.64 [95% CI, .55–.75]). IPT reduced the risk of TB by approximately 30% (aHR, 0.71 [95% CI, .63–.81]; absolute risk difference, 1518/100 000 women). The effect was modified by CD4 cell count with protection conferred if CD4 count was ≤350 cells/μL (aHR, 0.51 [95% CI, .41–.63]) vs 0.93 [95% CI, .76–1.13] for CD4 count &gt;350 cells/µL). Conclusions This analysis of programmatic data is reassuring regarding the safety of antenatal IPT, with the greatest benefits against TB disease observed in women with CD4 count ≤350 cells/μL.

scholarly journals The impact of antiretroviral therapy and isoniazid preventive therapy on tuberculosis incidence in HIV-infected patients in Rio de Janeiro, Brazil

AIDS ◽  
2007 ◽  
Vol 21 (11) ◽  
pp. 1441-1448 ◽  
Author(s):  
Jonathan E Golub ◽  
Valeria Saraceni ◽  
Solange C Cavalcante ◽  
Antonio G Pacheco ◽  
Lawrence H Moulton ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Rio De Janeiro ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
Tuberculosis Incidence ◽  
The Impact

scholarly journals Analysis of viral load change in Case of HIV/AIDS Patients under ART Follow-up in Arba Minch General Hospital

2021 ◽  
Author(s):  
Markos Erango ◽  
Kabtamu Gergiso ◽  
Sultan Hebo
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
General Hospital ◽  
Preventive Therapy ◽  
Isoniazid Preventive Therapy ◽  
Adherence Level ◽  
Immunodeficiency Virus ◽  
Over Time

Abstract Background: Monitoring human immunodeficiency virus plasma viral load over time is critical to identify virologic treatment failure in patients taking antiretroviral therapy. The aim of this study was to determine whether the overtime viral load changes depends on patient characteristic measured at baseline of human immunodeficiency virus patients at Arba Minch General Hospital.Methods: This prospective follow up study was conducted using data obtained from medical records, patient interviews, and laboratory workup for six months. The study was employed among 152 adult patients that were selected by systematic random sampling. Longitudinal data analysis that accounts for the correlated nature of the data handled through linear mixed effect models were used to fit the data set in this study.Result: The mean viral load declines over time for each of the adherence level groups. The estimates of linear (p = 0.0006) and quadratic visit time (p=0.0256) effects and the baseline characteristics sex, age, adherence level, and Isoniazid preventive therapy had significant effects on change of viral load of patients over time. Conclusion: In order to improve the status of the patient’s viral load over time, considering the patients’ differences in adherence to antiretroviral therapy, sex, age, and Isoniazid preventive therapy are important.

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