Journal Article > ResearchFull Text
Int J Tuberc Lung Dis. 1 October 2007
Ciglenecki I, Glynn JR, Mwinga A, Ngwira B, Zumla A, et al.
Int J Tuberc Lung Dis. 1 October 2007
SETTING: Randomised controlled clinical trial of Mycobacterium vaccae vaccination as an adjunct to anti-tuberculosis treatment in human immunodeficiency virus (HIV) positive patients with smear-positive tuberculosis (TB) in Lusaka, Zambia, and Karonga, Malawi. OBJECTIVE: To explain the difference in mortality between the two trial sites and to identify risk factors for death among HIV-positive patients with TB. DESIGN: Information on demographic, clinical, laboratory and radiographic characteristics was collected. Patients in Lusaka (667) and in Karonga (84) were followed up for an average of 1.56 years. Cox proportional hazard analyses were used to assess differences in survival between the two sites and to determine risk factors associated with mortality during and after anti-tuberculosis treatment. RESULTS: The case fatality rate was 14.7% in Lusaka and 21.4% in Karonga. The hazard ratio for death comparing Karonga to Lusaka was 1.47 (95% confidence interval [CI] 0.9-2.4) during treatment and 1.76 (95%CI 1.0-3.0) after treatment. This difference could be almost entirely explained by age and more advanced HIV disease among patients in Karonga. CONCLUSION: It is important to understand the reasons for population differences in mortality among patients with TB and HIV and to maximise efforts to reduce mortality.
Journal Article > ResearchFull Text
Lancet. 14 May 2014 (Issue 9944); DOI:10.1016/S0140-6736(14)60162-8
Rangaka MX, Wilkinson RJ, Boulle AM, Glynn JR, Fielding K, et al.
Lancet. 14 May 2014 (Issue 9944); DOI:10.1016/S0140-6736(14)60162-8
Antiretroviral therapy reduces the risk of tuberculosis, but tuberculosis is more common in people with HIV than in people without HIV. We aimed to assess the effect of isoniazid preventive therapy on the risk of tuberculosis in people infected with HIV-1 concurrently receiving antiretroviral therapy.
Journal Article > ResearchFull Text
Clin Infect Dis. 5 September 2012; Volume 55 (Issue 12); DOI:10.1093/cid/cis775
Rangaka MX, Wilkinson RJ, Glynn JR, Boulle AM, van Cutsem G, et al.
Clin Infect Dis. 5 September 2012; Volume 55 (Issue 12); DOI:10.1093/cid/cis775
Current symptom screening algorithms for intensified tuberculosis case finding or prior to isoniazid preventive therapy (IPT) in patients infected with human immunodeficiency virus (HIV) were derived from antiretroviral-naive cohorts. There is a need to validate screening algorithms in patients on antiretroviral therapy (ART).