Early Initiation of ARV Therapy Among TB–HIV Patients in Indonesia Prolongs Survival Rates!

Abstract

Background: The HIV epidemic remains a public health problem with rising tuberculosis (TB) numbers around the world. Antiretroviral (ARV) therapy (ART) is essential to increase the survival of patients with TB–HIV coinfection. The aim of this study is to investigate the effect of ARV treatment initiation within TB treatment duration for the survival of patients with TB–HIV coinfection. Methods: This is a retrospective cohort study of patients with TB–HIV coinfection and who were ARV naive from Prof. Dr. Sulianti Saroso Infectious Disease Hospital between January 2011 and May 2014 (N = 275). The Kaplan–Meier method, bivariate with the log rank test, and multivariate with the Cox regression were applied in this study. Results: Cumulative survival probability of the patients with TB–HIV coinfection receiving ARV in a year was 81.5%. The death rate in patients with TB–HIV coinfection who received late ART initiation during TB treatment is higher by 2.4 times [adjusted hazard ratio (aHR) = 2.4, 95% confidence interval: 1.3–4.5, p = 0.006] compared with the patients who were in early ART initiation and were thereafter adjusted by the location of Mycobacterium tuberculosis infection. Conclusion:The effect of ART initiation is essential in the intensive phase (2–8 weeks) of anti-TB medication to increase the survival among TB–HIV coinfection group.

Keywords

• Antiretroviral
• TB–HIV coinfection
• Survival analysis