{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T14:26:14Z","timestamp":1761488774976},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,10,3]],"date-time":"2011-10-03T00:00:00Z","timestamp":1317600000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Objectives\u2002<\/jats:bold> This study assesses the outcome of current treatment guidelines and the effect of highly active antiretroviral therapy (HAART) on survival of HIV\/TB\u2010coinfected patients in a resource\u2010limited setting.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> Observational cohort study at the pediatric HIV Clinic, RML Hospital, Delhi. All HIV\u2010infected patients who visited the clinic for the diagnosis of TB between 2002 and 2006 were observed until 31 March 2010. TB was diagnosed either at the time of enrolment or during follow\u2010up visits. Clinical and epidemiological data were registered. We compared children who were given HAART with TB treatment at time of diagnosis [simultaneous therapy (ST)] and children who received delayed HAART. Survival was assessed by Kaplan\u2013Meier method and Cox regression model.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Among the 298 children, 126 (42.2%) had TB, including 96 who received ST (76% of 126) and 30 who did not. There were no differences between the two groups except for a lower CD4 count in patients undergoing ST. ST was associated with improved survival [hazard ratio (HR), 0.35; 95% CI, 0.20\u20130.74; <jats:italic>P\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>0.002] and so were year of TB diagnosis and other AIDS\u2010defining conditions. Multivariate analysis revealed that ST was a powerful predictor of survival (HR, 0.30; 95% CI, 0.14\u20130.68; <jats:italic>P\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>0.003). After adjusting for other prognostic variables such as age, gender, CD4 count at time of TB diagnosis, by Cox multivariate analysis, ST remained robustly associated with improved survival (HR, 0.32; 95% CI, 0.17\u20130.71; <jats:italic>P\u2003<\/jats:italic>=<jats:italic>\u2003<\/jats:italic>0.001).<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> Starting HAART during tuberculosis therapy significantly improves survival and provides further impetus for the integration of TB and HIV services.<\/jats:p>","DOI":"10.1111\/j.1365-3156.2011.02884.x","type":"journal-article","created":{"date-parts":[[2011,10,4]],"date-time":"2011-10-04T03:56:25Z","timestamp":1317700585000},"page":"52-58","source":"Crossref","is-referenced-by-count":3,"title":["Simultaneous HAART improves survival in children coinfected with HIV and TB"],"prefix":"10.1111","volume":"17","author":[{"given":"Tripti","family":"Pensi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alok","family":"Hemal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tanushree","family":"Banerjee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,10,3]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)08904-3"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/518658"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/48.6.340"},{"key":"e_1_2_5_5_1","first-page":"705","article-title":"Factors associated with an increased case\u2010fatality rate in HIV\u2010infected and non\u2010infected South African gold miners with pulmonary tuberculosis","volume":"4","author":"Churchyard GJ","year":"2000","journal-title":"International Journal of Tuberculosis and Lung Disease"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.9.1009"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540120701235628"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.171.9.4689"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199201233260404"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1086\/424676"},{"key":"e_1_2_5_11_1","first-page":"1051","article-title":"Influence of highly active anti\u2010retroviral therapy (HAART) on the natural history of extra\u2010pulmonary tuberculosis in HIV patients","volume":"6","author":"Garc\u00eda de Olalla P","year":"2002","journal-title":"International Journal of Tuberculosis and Lung Disease"},{"key":"e_1_2_5_12_1","unstructured":"HavlirD IveP KendallMet\u00a0al.(2011)International randomized trial of immediate vs early ART in HIV+ patients treated for TB: ACTG 5221 STRIDE study [Abstract 38]. Presented at: 18th Conference on Retroviruses and Opportunistic Infections (CROI) Boston Massachusetts."},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/biostatistics\/1.4.465"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199509020-00005"},{"key":"e_1_2_5_15_1","volume-title":"AIDS Epidemic Update: December 2003","author":"Joint United Nations Programme on HIV\/AIDS\/World Health Organization","year":"2003"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0905848"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000230521.86964.86"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1086\/518655"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200101260-00002"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200509-1529OC"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(89)80747-4"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1086\/338641"},{"key":"e_1_2_5_23_1","volume-title":"RNTCP Status Report. Central TB Division","author":"TB India","year":"2007"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1086\/378676"},{"key":"e_1_2_5_25_1","first-page":"793","article-title":"Joint modeling of longitudinal and time\u2010to\u2010event data: an overview","volume":"14","author":"Tsiatis AA","year":"2004","journal-title":"Statistica Sinica"},{"key":"e_1_2_5_26_1","first-page":"110","article-title":"Low CD4\u2003+\u2003T\u2010cell count and high HIV viral load precede the development of tuberculosis disease in a cohort of HIV positive Ethiopians","volume":"7","author":"Wolday D","year":"2003","journal-title":"International Journal of Tuberculosis and Lung Disease"},{"key":"e_1_2_5_27_1","unstructured":"World Health Organisation(2003)Revised WHO guidelines for scaling up antiretroviral therapy in resource\u2010limited settings. revision.http:\/\/www.who.int\/hiv\/pub\/prev_care\/en\/arvrevision2003en.pdf."}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-3156.2011.02884.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-3156.2011.02884.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T14:14:40Z","timestamp":1697292880000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-3156.2011.02884.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,10,3]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2012,1]]}},"alternative-id":["10.1111\/j.1365-3156.2011.02884.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-3156.2011.02884.x","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,10,3]]}}}