{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,29]],"date-time":"2023-10-29T04:22:42Z","timestamp":1698553362938},"reference-count":22,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,4,17]],"date-time":"2013-04-17T00:00:00Z","timestamp":1366156800000},"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":[[2013,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To provide information on the effect of timing of antiretroviral therapy (<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>) initiation on outcomes of <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> infection in real\u2010life, non\u2010clinical trial, rural settings in sub\u2010<jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>aharan <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>frica.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted an observational cohort study of all <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> patients presenting to a rural hospital in <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>enya between 2005 and 2009. We analysed the association between timing of initiation of <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> and mortality, using a <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ox regression survival analysis, adjusted for measured confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 404 antiretroviral\u2010na\u00efve <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> coinfected patients were included in the study. Initiation of <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> during the first 8\u00a0weeks of <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> treatment (early group) was not associated with changes in mortality at 1\u00a0year compared with initiation of <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> after 8\u00a0weeks (late group) [Hazard Ratio (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>)\u00a0=\u00a00.74 (Confidence Interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>), 0.33\u20131.64, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.46]. In patients with baseline <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 counts \u226450\u00a0cells\/\u03bcl, there was a significant reduction in mortality in the early group compared with the late group (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\u00a0=\u00a00.20; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.042\u20130.99; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.049). In patients with a <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 count &gt;50\u00a0cells\/\u03bcl, there was no significant difference between early and late groups (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 1.79; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.64\u20135.03; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.27).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found that in <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> coinfected patients in rural <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>enya, early <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> initiation (within 8\u00a0weeks) was associated with reduced mortality in those with <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 counts \u226450\u00a0cells\/\u03bcl. In patients with <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 counts &gt;50\u00a0cells\/\u03bcl, there was no association seen between timing of <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> and mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12110","type":"journal-article","created":{"date-parts":[[2013,4,17]],"date-time":"2013-04-17T07:25:59Z","timestamp":1366183559000},"page":"907-914","source":"Crossref","is-referenced-by-count":4,"title":["Initiation of antiretroviral therapy in <scp>HIV<\/scp>\u2010infected tuberculosis patients in rural <scp>K<\/scp>enya: an observational study"],"prefix":"10.1111","volume":"18","author":[{"given":"Alexander J.","family":"Stockdale","sequence":"first","affiliation":[{"name":"Regional Infectious Diseases Unit Western General Hospital Edinburgh UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Nkuranga","sequence":"additional","affiliation":[{"name":"AIDS Relief HIV Programme PCEA Chogoria Hospital Chogoria Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. 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