학술논문
Same-day testing with initiation of antiretroviral therapy or tuberculosis treatment versus standard care for persons presenting with tuberculosis symptoms at HIV diagnosis: A randomized open-label trial from Haiti.
Document Type
article
Author
Nancy Dorvil; Vanessa R Rivera; Cynthia Riviere; Richard Berman; Patrice Severe; Heejung Bang; Kerlyne Lavoile; Jessy G Devieux; Mikerlyne Faustin; Giovanni Saintyl; Maria Duran Mendicuti; Samuel Pierre; Alexandra Apollon; Emelyne Dumond; Guyrlaine Pierre Louis Forestal; Vanessa Rouzier; Adias Marcelin; Margaret L McNairy; Kathleen F Walsh; Kathryn Dupnik; Lindsey K Reif; Anthony L Byrne; Stephanie Bousleiman; Eli Orvis; Patrice Joseph; Pierre-Yves Cremieux; Jean William Pape; Serena P Koenig
Source
PLoS Medicine, Vol 20, Iss 6, p e1004246 (2023)
Subject
Language
English
ISSN
1549-1277
1549-1676
1549-1676
Abstract
BackgroundSame-day HIV testing and antiretroviral therapy (ART) initiation is being widely implemented. However, the optimal timing of ART among patients with tuberculosis (TB) symptoms is unknown. We hypothesized that same-day treatment (TB treatment for those diagnosed with TB; ART for those not diagnosed with TB) would be superior to standard care in this population.Methods and findingsWe conducted an open-label trial among adults with TB symptoms at initial HIV diagnosis at GHESKIO in Haiti; participants were recruited and randomized on the same day. Participants were randomized in a 1:1 ratio to same-day treatment (same-day TB testing with same-day TB treatment if TB diagnosed; same-day ART if TB not diagnosed) versus standard care (initiating TB treatment within 7 days and delaying ART to day 7 if TB not diagnosed). In both groups, ART was initiated 2 weeks after TB treatment. The primary outcome was retention in care with 48-week HIV-1 RNA ConclusionsIn patients with TB symptoms at HIV diagnosis, we found that same-day treatment was not associated with superior retention and viral suppression. In this study, a short delay in ART initiation did not appear to compromise outcomes.Trial registrationThis study is registered with ClinicalTrials.gov NCT03154320.