does antiretroviral therapy affect tuberculosis outcomes?

Category: Tuberculosis

📊 56 findings in 7 studies

	Intervention	Condition	Outcome / Effect		Source
📊	antiretroviral therapy scale-up vs pre-ART scale-up period (2007)	HIV infection People living	ART scale-up was associated with a 5-fold decline in annual TB incidence rates among PLWH in care fr declined 5-fold from 5,960 to 985 per 10	↑	5902407 median 44 months
📊	antiretroviral therapy scale-up vs general population TB incidenc	HIV infection People living	ART scale-up was associated with significant decreases in SIRs, indicating a narrowing gap between T Kenya: 21.8 to 4.1 [p=0.0019]; Tanzania:	↑	5902407 median 44 months
📊	Antiretroviral vs untreated HIV-infected individ	HIV infection Adults	ART is associated with a 70-90% decrease in TB incidence rates among treated individuals, but TB inc 7.3 cases/100 person-years (overall); 70	↑	3801095 up to 4.5 years
📊	Antiretroviral vs lower CD4 cell strata	HIV infection Adults	TB incidence rates during ART decrease as updated CD4 cell count increases, with rates of 16.8/100 p 16.8 (0-100), 9.3 (101-200), 5.5 (201-30	↑	3801095 up to 4.5 years
📊	Antiretroviral vs long-term ART (>4 months)	HIV infection Adults	During early ART (first 4 months), patients with CD4 cell counts <200 cells/µl had a 1.7-fold higher adjusted IRR = 1.66 (early vs long-term)	↓	3801095 up to 4.5 years
📊	Antiretroviral vs CD4 >500 cells/µl	HIV infection Adults	TB incidence rates at CD4 cell counts of 200–500 cells/µl remained high (4.2–5.5 cases/100 person-ye 4.2–5.5 cases/100 person-years (200–500	↓	3801095 up to 4.5 years
📊	Antiretroviral vs other patient characteristics	HIV infection Adults	Updated CD4 cell counts were the only patient characteristic independently associated with long-term Updated CD4 cell count: strong associati	—	3801095 up to 4.5 years
📊	Antiretroviral vs long-term ART	HIV infection Adults	Unmasking TB may account for over one-third (40%) of TB cases presenting during the initial months o Excess proportion of TB cases during ear	↓	3801095 up to 4.5 years
📊	Antiretroviral vs CD4 >200 vs >500 cells/b5l	HIV infection Adults	Mortality risk is minimized at CD4 >200 cells/µl, but TB risk is only minimized at CD4 >500 cells/µl Mortality minimized at CD4 >200; TB mini	—	3801095 up to 4.5 years
📊	Antiretroviral vs CD4 <200 vs >500 eligibility	HIV infection Adults	ART eligibility criteria based on CD4 <200 cells/µl are not optimal for TB prevention, as TB risk is Current policy: eligibility at CD4 <200;	↓	3801095 up to 4.5 years
📊	Antiretroviral vs ART alone	HIV infection People living	Provision of IPT in combination with ART results in a greater reduction in TB risk and severe illnes Greater reduction in TB risk and severe	↑	5470840
📊	Antiretroviral vs shorter duration or no ART	HIV infection Children	Longer duration on antiretroviral therapy (ART) was associated with a reduced risk of incident tuber adjusted hazard ratio (aHR) 0.91 per mon	↑	5454479 mean 13.6 months
📊	Antiretroviral vs shorter duration or no ART	HIV infection Children	Longer duration on ART was associated with lower odds of prevalent TB at enrollment in HIV-infected adjusted odds ratio (aOR) 0.91 per month	↑	5454479 at enrollment
📊	Antiretroviral vs shorter duration or no ART	HIV infection Children	In bivariate analysis, each additional month on ART was associated with a lower risk of incident TB HR 0.92 per month on ART	—	5454479 mean 13.6 months
📊	Antiretroviral vs shorter duration or no ART	HIV infection Children	In bivariate analysis, each additional month on ART was associated with lower odds of prevalent TB a OR 0.94 per month on ART, P < 0.001	↑	5454479 at enrollment
📊	Antiretroviral vs no ART	HIV infection Children	Retrospective studies in sub-Saharan Africa have shown that ART is associated with a 5085% decrease Retrospective studies: 5085% decrease i	↑	5454479 varied
📊	Antiretroviral vs no ART	HIV infection Children	A prospective randomized controlled trial in South Africa demonstrated that ART prevents TB in child RCT: ART prevents TB in children with HI	↑	5454479 varied
📊	Antiretroviral vs historical rates (not directly	HIV infection Children	In a cohort of HIV-infected children with high ART use, the incidence of TB was 1.4 per 100 child-ye Incidence 1.4 per 100 child-years (95% C	↑	5454479 mean 13.6 months
📊	Antiretroviral vs delayed ART	HIV infection Children	Optimal TB prevention strategies should emphasize early ART in children with HIV. ART recommended as optimal TB prevention	↑	5454479 mean 13.6 months
📊	Delayed initiation of antiretroviral the vs ART initiation within 1 month	Multidrug-Resistant Tuberculosis Adults	Delayed initiation of ART (7 months after MDR-TB treatment start instead of within 1 month) resulted ART started 7 months after MDR-TB treatm	↓	3005763 24 months
📊	Antiretroviral vs ART alone	tuberculosis prevention People living	Provision of IPT in combination with ART results in a greater reduction in TB risk and severe illnes Greater reduction in TB risk and severe	↑	5470840
📊	Antiretroviral	Extensively Drug-Resistant Tubercul XDR-TB-HIV co-infected patient	Among XDR-TB-HIV co-infected patients on ARV, 88.2% reported optimal six-month adherence to ARV. 88.2%	↑	4410008 6 months
📊	Antiretroviral	Extensively Drug-Resistant Tubercul XDR-TB-HIV co-infected patient	Among XDR-TB-HIV co-infected patients on both TB medications and ARV, 64.3% reported optimal six-mon 64.3%	↑	4410008 6 months
📊	Antiretroviral vs second-line TB medications	Extensively Drug-Resistant Tubercul XDR-TB-HIV co-infected patient	Medication adherence was significantly higher for ARV (88.2%) than for TB medications (67.7%) at six ARV 88.2% vs TB medications 67.7%, p<0.0	↑	4410008 6 months
📊	Antiretroviral vs not on ARV	Extensively Drug-Resistant Tubercul XDR-TB patients	TB medication adherence was not significantly different between XDR-TB patients on ARV (65.7%) and t TB medication adherence: 65.7% (on ARV)	—	4410008 6 months
📊	Antiretroviral vs No antiretroviral therapy	Extensively Drug-Resistant Tubercul Patients	76% of HIV-infected XDR tuberculosis patients were receiving antiretroviral therapy. 76%	—	5330208 Cross-sectional at d
📊	Antiretroviral	HIV co-infection XDR-TB-HIV co-infected patient	Among XDR-TB-HIV co-infected patients on ARV, 88.2% reported optimal six-month adherence to ARV. 88.2%	↑	4410008 6 months
📊	Antiretroviral	HIV co-infection XDR-TB-HIV co-infected patient	Among XDR-TB-HIV co-infected patients on both TB medications and ARV, 64.3% reported optimal six-mon 64.3%	↑	4410008 6 months
📊	Antiretroviral vs second-line TB medications	HIV co-infection XDR-TB-HIV co-infected patient	Medication adherence was significantly higher for ARV (88.2%) than for TB medications (67.7%) at six ARV 88.2% vs TB medications 67.7%, p<0.0	↑	4410008 6 months
📊	Delayed initiation of antiretroviral the vs ART initiation within 1 month	HIV co-infection Adults	Delayed initiation of ART (7 months after MDR-TB treatment start instead of within 1 month) resulted ART started 7 months after MDR-TB treatm	↓	3005763 24 months
📊	antiretroviral therapy scale-up vs pre-ART scale-up period (2007)	Tuberculosis People living	ART scale-up was associated with a 5-fold decline in annual TB incidence rates among PLWH in care fr declined 5-fold from 5,960 to 985 per 10	↑	5902407 median 44 months
📊	antiretroviral therapy scale-up vs general population TB incidenc	Tuberculosis People living	ART scale-up was associated with significant decreases in SIRs, indicating a narrowing gap between T Kenya: 21.8 to 4.1 [p=0.0019]; Tanzania:	↑	5902407 median 44 months
📊	Antiretroviral vs no ART	Tuberculosis People living	Use of ART was associated with a lower hazard of incident TB among PLWH in care. lower hazard of incident TB (adjusted Co	↑	5902407
📊	Antiretroviral vs untreated HIV-infected individ	Tuberculosis Adults	ART is associated with a 70-90% decrease in TB incidence rates among treated individuals, but TB inc 7.3 cases/100 person-years (overall); 70	↑	3801095 up to 4.5 years
📊	Antiretroviral vs lower CD4 cell strata	Tuberculosis Adults	TB incidence rates during ART decrease as updated CD4 cell count increases, with rates of 16.8/100 p 16.8 (0-100), 9.3 (101-200), 5.5 (201-30	↑	3801095 up to 4.5 years
📊	Antiretroviral vs long-term ART (>4 months)	Tuberculosis Adults	During early ART (first 4 months), patients with CD4 cell counts <200 cells/µl had a 1.7-fold higher adjusted IRR = 1.66 (early vs long-term)	↓	3801095 up to 4.5 years
📊	Antiretroviral vs CD4 >500 cells/µl	Tuberculosis Adults	TB incidence rates at CD4 cell counts of 200–500 cells/µl remained high (4.2–5.5 cases/100 person-ye 4.2–5.5 cases/100 person-years (200–500	↓	3801095 up to 4.5 years
📊	Antiretroviral vs person-time at CD4 >500 cells/	Tuberculosis Adults	Despite immune recovery, 88% of person-time during ART was spent at CD4 cell counts <500 cells/µl, a 88% of person-time at CD4 <500 cells/b5	↓	3801095 up to 4.5 years
📊	Antiretroviral vs baseline CD4 >100 cells/b5l	Tuberculosis Adults	Patients with baseline CD4 ≤100 cells/µl accrued 40% of person-time at CD4 0–200, compared to 17% fo 40% of person-time at CD4 000 for basel	↓	3801095 up to 4.5 years
📊	Antiretroviral vs other patient characteristics	Tuberculosis Adults	Updated CD4 cell counts were the only patient characteristic independently associated with long-term Updated CD4 cell count: strong associati	—	3801095 up to 4.5 years
📊	Antiretroviral vs long-term ART	Tuberculosis Adults	Unmasking TB may account for over one-third (40%) of TB cases presenting during the initial months o Excess proportion of TB cases during ear	↓	3801095 up to 4.5 years
📊	Antiretroviral vs CD4 >200 vs >500 cells/b5l	Tuberculosis Adults	Mortality risk is minimized at CD4 >200 cells/µl, but TB risk is only minimized at CD4 >500 cells/µl Mortality minimized at CD4 >200; TB mini	—	3801095 up to 4.5 years
📊	Antiretroviral vs HIV-seronegative adults	Tuberculosis Adults	TB incidence rate in ART patients with CD4 >500 cells/µl is 1.5/100 person-years, about two-fold hig 1.5 cases/100 person-years (ART, CD4 >50	↓	3801095 up to 4.5 years
📊	Antiretroviral vs CD4 <200 vs >500 eligibility	Tuberculosis Adults	ART eligibility criteria based on CD4 <200 cells/µl are not optimal for TB prevention, as TB risk is Current policy: eligibility at CD4 <200;	↓	3801095 up to 4.5 years
📊	Antiretroviral vs none	Tuberculosis Adults	Among patients receiving ART, 10.5% died, 11.2% were lost to follow-up, and 6.1% were transferred or 10.5% died, 11.2% lost to follow-up, 6.1 Side effects: 10.5% died, 11.2% lost to follow-up, 6.1% transfer	↓	3801095 up to 4.5 years
📊	Antiretroviral vs shorter duration or no ART	Tuberculosis Children	Longer duration on antiretroviral therapy (ART) was associated with a reduced risk of incident tuber adjusted hazard ratio (aHR) 0.91 per mon	↑	5454479 mean 13.6 months
📊	Antiretroviral vs shorter duration or no ART	Tuberculosis Children	Longer duration on ART was associated with lower odds of prevalent TB at enrollment in HIV-infected adjusted odds ratio (aOR) 0.91 per month	↑	5454479 at enrollment
📊	Antiretroviral vs shorter duration or no ART	Tuberculosis Children	In bivariate analysis, each additional month on ART was associated with a lower risk of incident TB HR 0.92 per month on ART	—	5454479 mean 13.6 months
📊	Antiretroviral vs shorter duration or no ART	Tuberculosis Children	In bivariate analysis, each additional month on ART was associated with lower odds of prevalent TB a OR 0.94 per month on ART, P < 0.001	↑	5454479 at enrollment
📊	Antiretroviral vs no ART	Tuberculosis Children	Retrospective studies in sub-Saharan Africa have shown that ART is associated with a 5085% decrease Retrospective studies: 5085% decrease i	↑	5454479 varied
📊	Antiretroviral vs no ART	Tuberculosis Children	A prospective randomized controlled trial in South Africa demonstrated that ART prevents TB in child RCT: ART prevents TB in children with HI	↑	5454479 varied
📊	Antiretroviral vs no ART or IPT	Tuberculosis Children	A prospective randomized controlled trial in South Africa demonstrated that ART and IPT prevent TB s RCT: ART + IPT prevent TB in combination	↑	5454479 varied
📊	Antiretroviral vs historical rates (not directly	Tuberculosis Children	In a cohort of HIV-infected children with high ART use, the incidence of TB was 1.4 per 100 child-ye Incidence 1.4 per 100 child-years (95% C	↑	5454479 mean 13.6 months
📊	Antiretroviral vs historical rates (not directly	Tuberculosis Children	In a cohort of HIV-infected children with high ART use, the prevalence of TB at enrollment was 7.4%. Prevalence 7.4% at enrollment in high AR	↑	5454479 at enrollment
📊	Antiretroviral vs delayed ART	Tuberculosis Children	Optimal TB prevention strategies should emphasize early ART in children with HIV. ART recommended as optimal TB prevention	↑	5454479 mean 13.6 months
📊	Antiretroviral vs No antiretroviral therapy	HIV Coinfection Patients	76% of HIV-infected XDR tuberculosis patients were receiving antiretroviral therapy. 76%	—	5330208 Cross-sectional at d

Synopsis

Antiretroviral therapy (ART) scale-up was associated with a 5-fold decline in annual tuberculosis (TB) incidence rates among people living with HIV (PLWH) in care, dropping from 5,960 to 985 per 100,000 person-years between 2007 and 2012 (p=0.0003). (5902407) ART is associated with a 70-90% decrease in TB incidence rates among treated individuals, though TB incidence during ART remains elevated at 7.3 cases per 100 person-years compared to untreated individuals. (3801095) Longer duration on ART is linked to a reduced risk of incident TB in HIV-infected children, with an adjusted hazard ratio of 0.91 per month on ART (p=0.003). (5454479) A prospective randomized controlled trial in South Africa demonstrated that ART prevents TB in children with HIV, supporting its role in TB prevention. (5454479)

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