Effect of highly active anti-retroviral treatment on TB incidence among HIV infected children and their clinical profile, retrospective Cohort study, South West Ethiopia

Retrospective Cohort ◽

Structural Model ◽

Clinical Profile ◽

Marginal Structural Model ◽

Highly Active ◽

Abstract Background: Children younger than 15 years, carries almost 80% of the global burden of HIV/ AIDS. Nearly, 50% of cases of tuberculosis are attributed to HIV infection. HIV worsen the progression of latent TB to active TB disease. Despite antiretroviral treatment has shown marked reduction in Tuberculosis incidence , TB continues to occur in Sub Saharan country including Ethiopia. The effect of highly active antiretroviral treatment is quite successful in developed country while in developing country TB/HIV co-infection remains perplexing among children on the treatment. The aim of the study was to investigate the impact of ART on the incidence of tuberculosis among Children infected with HIV in southwest Ethiopia. Methods: A retrospective cohort study was conducted on randomly selected 800 samples from ART clinic; between 2009 to 2014. We used chi-square test, and Mann-WhitneyU test to compare HAART naïve and HAART cohort. We used marginal structural models to estimate the effect of HAART on survival while accounting for time-dependent confounders affected by exposure. Result: A total of 844 children were followed for 2942.99 child-years. The children were observed for a median of 51 months with IQR 31 and for a total of 2942.99 child-years. From 506 OIs that occurred, the most common reported OIs were Pneumonia (22%) and TB (23.6 %). The overall TB incidence rate was 7.917 per 100 child years (95% CI, 6.933-9.002). Whereas among HAART (7.667 per 100 -years (95% CI, 6.318-9.217) and 8.1686 per 100 person-years (95% CI 6.772-9.767) for HAART naïve. The mortality hazard ratio comparing HAART with no HAART from a marginal structural model was 0.642 (95% CI 0.442-0.931, p<0.02) Conclusions: HAART reduced the hazard of TB in HIV-infected children by 36%. This is by far less than expected. Key Words- TB incidence, HAART, Clinical Profile ted children by 36%. This is by far less than expected. Key Words- TB incidence, HAART, Clinical Profile

Effect of highly active antiretroviral treatment on TB incidence among HIV infected children and their clinical profile, retrospective cohort study, South West Ethiopia

Scientific Reports ◽

10.1038/s41598-020-78466-0 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Firew Tiruneh ◽

Yared Deyas

Keyword(s):

Cohort Study ◽

Retrospective Cohort ◽

Structural Model ◽

Developed Countries ◽

Hiv Treatment ◽

Highly Active ◽

Highly Active Antiretroviral Treatment ◽

AbstractGlobally, 1.8 million HIV infected children live with HIV; nearly 53% of them were receiving HIV treatment. People who are infected with HIV are 18 times more likely to develop active TB. Despite antiretroviral treatment has shown marked reduction in TB incidence, TB continues to occur in Sub-Saharan countries including Ethiopia among HIV infected people. The effect of highly active antiretroviral treatment is quite successful in developed countries. However, in developing country TB/HIV co-infection remains perplexing among children on the treatment. The aim of this study was to investigate the impact of ART on the incidence of TB among Children infected with HIV in Southwest Ethiopia. A retrospective cohort study was conducted on randomly selected 800 samples from ART clinic between 2009 and 2014. We used chi-square test, and Mann–Whitney U test to compare HAART naïve and HAART cohort. We used marginal structural models to estimate the effect of HAART on survival while accounting for time-dependent confounders affected by exposure. A total of 800 children were followed for 2942.99 child-years. The children were observed for a median of 51 months with IQR 31 and for a total of 2942.99 child-years. From 506 OIs that occurred, the most common reported OIs were Pneumonia (22%) and TB (23.6%). The overall TB incidence rate was 7.917 per 100 child years (95% CI, 6.933–9.002). Whereas among HAART (7.667 per 100-years (95% CI, 6.318–9.217) and 8.1686 per 100 person-years (95% CI 6.772–9.767) for HAART naïve. The mortality hazard ratio comparing HAART with no HAART from a marginal structural model was 0.642 (95% CI 0.442–0.931, p < 0.02). HAART reduced the hazard of TB in HIV-infected children by 36%. This is by far less than expected.

The Impact of Universal Test and Treat Program on Highly Active Anti Retroviral Therapy Outcomes (Coverage, Adherence and Lost to Follow Up) at Wangaya Hospital in Denpasar, Bali-Indonesia: A Retrospective Cohort Study

The Open AIDS Journal ◽

10.2174/1874613602115010028 ◽

2021 ◽

Vol 15 (1) ◽

pp. 28-34

Author(s):

Ketut Suryana

Keyword(s):

Cohort Study ◽

Retrospective Cohort ◽

Hiv Treatment ◽

Highly Active ◽

Universal Test And Treat ◽

High Adherence ◽

Lost To Follow Up ◽

Background: World Health Organization (WHO) (2015) recommended that all people diagnosed with human immunodeficiency virus (HIV)-positive initiate Highly Active Anti Retroviral Therapy (HAART) immediately (less than a week), irrespective of CD4 count (Universal Test and Treat / UTT) Program. Objective: To evaluate the impact of UTT as a current therapeutic program on HIV treatment outcomes, coverage, adherence, and lost to follow-up (LTFU) at Wangaya Hospital in Denpasar, Bali, Indonesia. Methods: A Retrospective cohort study was conducted during July 2017 - June 2018 (Pre-UTT) and September 2018 – August 2019 (Post-UTT). Around 402 medical records were selected, reviewed, and enrolled. Data were analyzed using SPSS software for windows version 24.0. Bivariate analysis (Chi-square test) was performed on all variables with a statistically significant t level of 0.05. Results: Among 4,322 new visitors; 3,585 (82.95%) agreed to take HIV test and 402(11.21%) were confirmed HIV reactive. Most participants confirmed HIV reactive occured at age 25-34 years old and 230 (57.21%) were male. The majority education level were primary (Junior high school) 302(75.12%), 379(94.28%) were employed and 281 (69.90%) stayed in Denpasar. About 350 (87.06%) received HAART, 298 (85.14%) with high adherence and 52 (14.86%) LTFU. Pre-UTT, HAART coverage; 83.03% (181), were statistically significant increased to 91.85% (169) post UTT (p=0.000). High adherence pre-UTT; 79.56% (144) was significantly increased to 91.12% (154) post UTT (p=0.006) and LTFU were significantly decreased; 20.44% (37) to 8.87% (15) (p=0.006). Conclusion: UTT program significantly improve the HIV treatment outcome (increased coverage, adherence, and decreased LTFU).

The impact of HIV status and antiretroviral treatment on TB treatment outcomes of new tuberculosis patients attending co-located TB and ART services in South Africa: a retrospective cohort study

BMC Infectious Diseases ◽

10.1186/s12879-015-1275-3 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 15

Author(s):

Mweete D. Nglazi ◽

Linda-Gail Bekker ◽

Robin Wood ◽

Richard Kaplan

Keyword(s):

South Africa ◽

Cohort Study ◽

Treatment Outcomes ◽

Retrospective Cohort ◽

Hiv Status ◽

Tuberculosis Patients ◽

Tb Treatment ◽

How Far Does Highly Active Antiretroviral Treatment Reduce TB Incidence among Children? A Marginal Structural Modeling Analysis, Southwest Ethiopia

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v30i5.3 ◽

2020 ◽

Vol 30 (5) ◽

Author(s):

Firew Tiruneh ◽

Yared Deyas

Keyword(s):

Structural Model ◽

Structural Modeling ◽

Marginal Structural Model ◽

Chi Square ◽

Highly Active ◽

Chi Square Test ◽

Sub Saharan ◽

The Impact ◽

Marginal Structural Modeling

BACKGROUND: Children younger than 15 years, carry almost 80% of the global burden of HIV/AIDS. HIV worsens the progression of latent TB to active TB disease. Although antiretroviral treatment has shown marked reduction in Tuberculosis incidence, TB continues to occur in Sub-Saharan countries including Ethiopia. The aim of this study was to investigate the impact of HAART on the incidence of tuberculosis among children infected with HIV in Southwest Ethiopia.METHODS: A retrospective cohort study was conducted between 2009 to 2014. We used chi-square test, and Mann-Whitney U test to compare non-HAART and HAART cohort. We estimated the effect of HAART on TB incidence using marginal structural model after adjusting for time dependent confounders affected by exposure.RESULT: A total of 844 children were followed. We observed them for a median of 51 months (IQR 31) and a total of 2942.99 child-years. The overall TB incidence rate was 7.917 per 100 child years (95% CI, 6.933-9.002). TB incidence for specific HAART and non-HAART cohort were 7.67 per 100 child-years (95% CI, 6.318-9.217) and 8.17 per 100 child-years (95% CI, 6.772-9.767) respectively. From marginal structural modeling, children on HAART were 36% (HR=0.642, 95% CI 0.442-0.931, p<0.02) less likely to develop TB compared to those who were not.CONCLUSION: HAART reduced the hazard of TB in HIVinfected children by 36%. This is by far less than what is expected.