ANTIRETROVIRAL ROLE IN TUBERCULOSIS PREVENTION AMONG PEOPLE LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS (RETROSPECTIVE COHORT CLINICAL STUDY)
https://doi.org/10.22625/2072-6732-2018-10-1-89-95
Abstract
Antiretroviral therapy is one of the most effective strategies for preventing tuberculosis among people living with HIV. It significantly reduces the risk of tuberculosis, regardless of immunosuppression level, results of tuberculin tests and prevalence of drug-resistant tuberculosis in the region. The results of the retrospective cohort study conducted at the Pskov Regional AIDS Center from 2007–2016 convincingly confirmed the importance of the ART in preventing the TB development in patients with HIV. Of the 814 subjects included in the study, 590 – received ART, 305 – did not receive it. In compared groups TB was more likely developed in patients without antiretroviral therapy, RR 0,37 (95% CI 0,20–0,49), they were more likely to die of tuberculosis, RR 0,20 (95% CI 0,065-0,4), and among them more likely occurred other opportunistic diseases, RR 0,53 (95% CI 0,35–0,75). Among those receiving ARVT, tuberculosis and other opportunistic diseases developed more often in individuals with CD4 350 cells/ml, there were no lethal outcomes of tuberculosis, RR 0.23 (95% CI 0.0-2.0).
About the Authors
Z. M. Zagdyn
Saint-Petersburg Science Research Institute of Phthisiopulmonology
Russian Federation
Russian Federation
I. L. Sivacheva
Pskov Regional AIDS Center
Russian Federation
Russian Federation
E. A. Zverkova
Pskov Regional AIDS Center
Russian Federation
Russian Federation
M. V. Beltyukov
Saint-Petersburg Science Research Institute of Phthisiopulmonology
Russian Federation
Russian Federation
E. G. Sokolovich
Saint-Petersburg Science Research Institute of Phthisiopulmonology
Russian Federation
Russian Federation
References
1. Stephen D Lawn, Robert J Wilkinson. ART and prevention of HIV-associated tuberculosis // The Lancet HIV. – June 2015. – Volume 2, No. 6, e221–e222. – DOI: http://dx.doi. org/10.1016/S2352-3018(15)00081-8.
2. Amitabh B. Suthar, Stephen D. Lawn, Julia del Amo, Haileyesus Getahun, Christopher Dye, Delphine Sculier, Timothy R. Sterling, Richard E. Chaisson, Brian G. Williams, Anthony D. Harries, Reuben M. Granich. Antiretroviral Therapy for Prevention of Tuberculosis in Adults with HIV: A Systematic Review and Meta-Analysis // PLoS Medicine. – July 2012. – Volume 9, Issue 7, e1001270. www.plosmedicine.org 1.
3. The TEMPRANO ANRS 12136 Study Group* A Trial of Early Antiretrovirals and Isoniazid Preventive Therapy in Africa // N Eng J Med. – August 27, 2015. – 373:808-22. – DOI: 10.1056/NEJMoa1507198.
4. The INSIGHT START Study Group. Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection //N Engl J Med. – 2015. – 373:795-80. – DOI: 10.1056/NEJMoa1506816.
5. “Rukovodstvo o vremeni naznacheniya antiretrovirusnoy terapii I po dokontaktnoy profilaktike” – sentyabr, 2015, VOZ
6. 90-90-90 An ambitious treatment target to help end the AIDS. UNAIDS, 2014 // epidemichttp://www.unaids.org/en/ resources/documents/2017/90-90-90
7. Prikaz Minzdravsotsrazvitiya RF ot 09.07.2007 # 474 “Ob utverzdenii standarta meditsinskoy pomoshi bolnym bolezny, vyzvannoy virusom immunodefitsita cheloveka (VICH)”
8. Nechaeva O.B. VICH-infectsiya I ee vliyanie na razvitie epidemicheskogo protsessa pri tuberculoze // Meditsinskiy Alphabit. / – 2015. – T.3, #21. – S. 5-10.
9. Nechaeva O. B. Situatsiya po tuberculozu I VICH-infectsii v Rossii //Tuberculez i bolezni leghkih. – 2014.- T. 91, #6. – S. 9-16.
10. Pokrovskiy VV, Yurin OG, Kravchenko AV, Belyaeva VV, Kanestri VG, Afonina L.Yu., Ermak TN, Buravtsova EV, Shakhgildyan VI, Kozyrina NV, Narsia RS, Zimina VN, Pokrovskaya AV, Efremova O.S. Protocoly dispansernogo nabludeniya I lecheniya bolnyh VICH-infectsiey //Epidemiologiya I infectsionnye bolezni. – 2014. – № 6. – S. 17.
11. Belyaeva VV, Ermak TN, Zimina VN, Kanestri VG, Kozyrina NV, Kravchenko AV, Pokrovsky VV, Shakhgildyan VI, Yurin O.G. VICH-INFECTSIYA I SPID. Klinicheskie recomendatsii / Pod redactsiey V.V. Pokrovskogo. Moskva, 2016 (3 izdanie, pererabotannoe I dopolnennoe).
12. Pokrovsky V.V. STRATEGIYA VIZDIDANIYA // Epidemiologiya i infectsionnye bolezni. Actualniy voprosy. – 2015. – № 1. – S. 4-9.
13. Lazareva A.C., Gavrilov P.V., Reschetneva E.V., Malaschenkov E.A., Juravlev V.Yu., Yablonskiy P.K. Osobennosti verificatsii tuberculeza legkih u bolnyh s VICH-infectsiey I nizkim urovnem CD4-kletok (<200 rl/mkl) // Tuberculez I bolezni legkih. – 2015. – #7. – S. 82-83.
14. Zimina V.N., Kravchenko A.V., Batyrov F.A., Vasileva I.A., Toschevikov M.V., Maltsev R.V. Generalizovanniy tuberculez u bolnyh VICH-infectsiey na stadia vtorichnyh zabolevaniy //Infektsionnye zabolevaniya. – 2010. – V8, #3. – S. 5-8
15. Panteleev A.M. Klinicheskoe predstavlenie o patogeneze generalizatsii tuberculeza u bolnuh VICH-infectsiey //Tuberculez I bolezni legkih. – 2015. – (2). – S. 26-31
16. “Svedeniya o kontingentah bolnyh BICH-infectsiey”, forma # 61 Federalnogo gosudarstvennogo statisticheskogo nabludeniya za 2007-2016 gody
Review
For citations:
Zagdyn Z.M., Sivacheva I.L., Zverkova E.A., Beltyukov M.V., Sokolovich E.G. ANTIRETROVIRAL ROLE IN TUBERCULOSIS PREVENTION AMONG PEOPLE LIVING WITH HUMAN IMMUNODEFICIENCY VIRUS (RETROSPECTIVE COHORT CLINICAL STUDY). Journal Infectology. 2018;10(1):89-95. (In Russ.) https://doi.org/10.22625/2072-6732-2018-10-1-89-95
Views:
993
.png)
.png)
Email this article 