A pilot study of once-daily antiretroviral therapy integrated with Tuberculosis directly observed therapy in a resource-limited setting.
Lalloo, Umesh Gangaram.
Abdool Karim, Quarraisha.
Abdool Karim, Salim Safurdeen.
Friedland, Gerald H.
MetadataShow full item record
To determine the feasibility and effectiveness of integrating highly active antiretroviral therapy (HAART) into existing tuberculosis directly observed therapy (TB/DOT) programs, we performed a pilot study in an urban TB clinic in South Africa. Patients with smear-positive pulmonary TB were offered HIV counseling and testing. Twenty HIV-positive patients received once-daily didanosine (400 mg) plus lamivudine (300 mg) plus efavirenz (600 mg) administered concomitantly with standard TB therapy Monday to Friday and self-administered on weekends. After completing TB therapy, patients were referred to an HIV clinic for continued treatment. At baseline, patients had a mean CD4 count of 230 cells/mm3 (range: 24–499 cells/mm3) and a mean viral load of 5.75 log10 (range: 3.81–7.53 log10). Seventeen completed combined standard TB and HIV therapy; 16 of 20 (80%) patients enrolled and 15 of 17 (88%) patients completing standard TB therapy achieved a viral load <50 copies/mL and mean CD4 count increase of 148 cells/mm3. TB was cured in 17 of 20 (85%) enrolled patients and 17 of 19 (89%) patients with drug-sensitive TB. Treatment was well tolerated, with minimal gastrointestinal, hepatic, skin, or neurologic toxicity. The project was well accepted and integrated into the daily TB clinic functions. This pilot study demonstrates that TB/DOT programs can be feasible and effective sites for HIV identification and the introduction and monitoring of a once-daily HAART regimen in resource-limited settings.
Showing items related by title, author, creator and subject.
A comparative study to determine the immediate effects of paraffin wax and moist heat therapies on pain, joint range of movement and grip ability in adults with rheumatoid arthritis afffecting the hands. Ramsudh, Thirusha. (2015-01-08)Physiotherapists use many treatment modalities in the management of rheumatoid arthritis of the hand. Two commonly used heating modalities are moist heat and paraffin wax therapy. The aim of this study was thus to compare ...
Re-inventing adherence : toward a patient-centered model of care for drug-resistant tuberculosis and HIV. Max Roe, O’Donnell.; Daftary, Amrita.; Frick, Mike.; Hirsch-Moverman, Yael.; Amico, Rivet K.; Senthilingam, Meera.; Wolf, Allison.; Metcalfe, John Z.; Isaakidis, Petros.; Davis, Luke J.; Zelnick, Jennifer R.; Brust, James C.M.; Naidu, Naressa.; Garretson, Marné.; Bangsberg, David R.; Padayatchi, Nesri.; Friedland, Gerald. (International Union against Tuberculosis and Lung Disease., 2016)Abstract available in PDF file.
Factors affecting attendance and participation in group therapy in a private inpatient psychiatric setting. Clark, Vicky Lilian-Ann. (2015)This study seeks to understand why many patients did not participate in a group therapy programme offered at an inpatient psychiatric hospital in Pietermaritzburg, South Africa. Conducted by an Occupational Therapist, the ...