Outcome of HAART in patients with tuberculosis in the Themba Lethu clinical cohort

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dc.contributor.author Akiy, Zeh Zacheaus
dc.date.accessioned 2009-05-21T13:07:51Z
dc.date.available 2009-05-21T13:07:51Z
dc.date.issued 2009-05-21T13:07:51Z
dc.identifier.uri http://hdl.handle.net/10539/6964
dc.description.abstract Introduction: The burden of disease due to HIV/AIDS and tuberculosis remains great for many countries around the world. Continuing attention must be devoted to these epidemics if we ever hope to one day contain their devastating effects on humankind. The objective of this study is to; to evaluate and compare cohort treatment outcomes of HIV infected TB patients and HIV infected non-TB patients treated with HAART at the Themba Lethu Clinic between 1st April 2004 and 1st April 2007. To measure outcomes in CD4, viral load, hemoglobin, liver function tests, weight, BMI, loss to follow up and death and to compare this outcomes between HIV patients who have had TB and HIV patients who have never had TB. Materials and Methods: information collected of patients for three years shall be used to carry out analysis. A total of 5818 patients were included in the cohort sample. 19.23% (1,048) of the patients had been diagnosed with TB at some point in time while 80.77% (4,770) had never been diagnosed with TB. Mean baseline CD4 cell counts were 113.47cells/mm3 for non TB patients and 88.85cells/mm3 for those who have ever had TB. This baseline CD4 counts are considered 2 months prior to ARV start and 1 month post the start of ARV. Baseline means for weight, BMI, AST and ALT were also taken into consideration by the two patient groups. Clinical out come was assessed and evaluated by comparing incidence of designated end points either as survival or failures. Incidence of deaths and loss to follow up was also compared in the two groups of patients. Results: Among HIV non TB patients, incidence rate of them having CD4 counts greater than 200 was at 36.47 persons per 10000 person days while for the patients who had been diagnosed with TB incidence of CD4 rising to above x 200 was lower at 34.19persons per 10000 person days. A rate ratio of 0.94 (95% CI 0.85 - 1.03) showed no true difference in the two groups. When looking at deaths in the two groups of patients, incidence in those who had TB was 3.84 deaths per 100 patient years and 4.16 deaths per 100 patient years for the non TB group with RR 0.93 and CI 0.66 - 1.28. Differences in incidence and outcomes were noticed in Hb gain, weight and BMI change, Liver function test changes over time and loss to follow up “defaulters”. Survival curves were modeled to show trend of change and log rank test were used to ascertain equality of survival curves. Where log rank p. values < 0.05 were noticed among survival curves of weight, BMI, AST, ALT, Hb and Loss to follow up. This again showed differences in weight, BMI, hemoglobin, AST, ALT and loss to follow up while no statistical differences were recognized between the two groups of patients when considering changes in CD4, deaths and Viral load over time as log rank test failed to reject the null hypothesis of similar curves. Conclusion: Data indicated that similarity and differences between HIV TB patients and HIV non TB patients could vary along certain outcomes. But one sure point is both groups of patients had an equal chance of staying alive when properly treated with ARV/HAART. en
dc.language.iso en en
dc.subject HAART en
dc.subject tuberculosis en
dc.subject HIV en
dc.title Outcome of HAART in patients with tuberculosis in the Themba Lethu clinical cohort en
dc.type Thesis en

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