Original Research

Effectiveness of early initiation of antiretroviral therapy in adults with HIV associated tuberculosis in Lesotho in 2012

Maletsatsi Lenela, Stephen Knight
Southern African Journal of Infectious Diseases | Vol 32, No 3 | a44 | DOI: https://doi.org/10.4102/sajid.v32i3.44 | © 2019 Maletsatsi Lenela, Stephen Knight | This work is licensed under CC Attribution 4.0
Submitted: 14 May 2019 | Published: 01 October 2017

About the author(s)

Maletsatsi Lenela, Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, South Africa
Stephen Knight, Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, South Africa

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Abstract

Background:Lesotho has a huge burden of human immunodeficiency virus associated tuberculosis (HIV-TB). In this study we compared the effectiveness of early versus late commencement of antiretroviral therapy (ART) in adults living with HIV-TB in Lesotho.

Methods: Three out of 17 hospitals were randomly selected and data extracted from the hospitals’ tuberculosis (TB) treatment registers for 247 adults living with HIV-TB who completed TB therapy during the first quarter of 2012.

Results: Eighty (32%) commenced ART early (<4 weeks), 100 (41%) were started late (≥4 weeks) and 67 (27%) received no ART. Both early and late ART initiators were more likely to have a successful TB outcome (Adjusted Odds Ratio (AOR) 10.1, 95% CI: 3.7 - 27.5 and AOR 8.4, 95% CI: 3.4 - 20.6, respectively) relative to the group who had no ART (p < 0.001).

Conclusions: Effective treatment exists for managing HIV-TB simultaneously. The guidelines for initiation of ART in adult HIV-TB in Lesotho have not been fully implemented, but those who commenced ART had significant clinical benefits. Health departments must address the challenges encountered in treating HIV-TB simultaneously to ensure those co-infected receive optimal care.


Keywords

low income country; tuberculosis treatment

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