Impact of Antiretroviral Therapy on Tuberculosis Incidence in Brazil
Author Information
Author(s): Miranda Abraham, Morgan Meade, Jamal Leda, Laserson Kayla, Barreira Draurio, Silva Guida, Santos Joseney, Wells Charles, Paine Patricia, Garrett Denise
Primary Institution: The Global AIDS Program, United States Centers for Disease Control and Prevention
Hypothesis
Did Brazil's policy of universal ART access impact TB incidence among HIV-infected patients?
Conclusion
The study shows an 80% reduction in TB incidence among HAART-treated HIV-infected patients compared to those who remained ART-naïve.
Supporting Evidence
- HAART-treated patients had a significantly lower incidence of TB compared to ART-naïve patients.
- Patients with a baseline CD4+ T-lymphocyte count <200 cells/mm3 had a higher incidence of TB.
- Prior hospitalization and incarceration were associated with increased TB incidence.
Takeaway
This study found that giving HIV patients medicine called HAART helps them get much less tuberculosis, which is a serious illness.
Methodology
The study abstracted clinical information from records of HIV-infected patients in Brazil from 1995 to 2001 and analyzed TB incidence using Cox proportional hazards analysis.
Potential Biases
The study may have been biased due to reliance on clinical grounds for TB diagnosis and potential misclassification of TB cases.
Limitations
The study excluded children and pregnant women, and relied on clinical diagnoses of TB, which may have led to underestimation of TB incidence.
Participant Demographics
The median age of participants was 34 years, with 70% male.
Statistical Information
P-Value
p<0.01
Confidence Interval
(95% CI 0.1, 0.6)
Statistical Significance
p<0.01
Digital Object Identifier (DOI)
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