Adherence to Concurrent Tuberculosis Treatment and Antiretroviral Treatment among Co-Infected Persons in South Africa, 2008–2010

Details

• Alternative Title:
  PLoS One
• Personal Author:
  Webb Mazinyo, Ernesha ; Kim, Lindsay ; Masuku, Sikhethiwe ; Lancaster, Joey L. ; Odendaal, Ronel ; Uys, Margot ; Podewils, Laura Jean ; Van der Walt, Martie L.
• Description:
  Background
  
  Adherence to tuberculosis (TB) treatment and antiretroviral therapy (ART) reduces morbidity and mortality among persons co-infected with TB/HIV. We measured adherence and determined factors associated with non-adherence to concurrent TB treatment and ART among co-infected persons in two provinces in South Africa.
  
  Methods
  
  A convenience sample of 35 clinics providing integrated TB/HIV care was included due to financial and logistic considerations. Retrospective chart reviews were conducted among persons who received concurrent TB treatment and ART and who had a TB treatment outcome recorded during 1 January 2008–31 December 2010. Adherence to concurrent TB and HIV treatment was defined as: (1) taking ≥80% of TB prescribed doses by directly observed therapy (DOT) as noted in the patient card; and (2) taking >90% ART doses as documented in the ART medical record during the concurrent treatment period (period of time when the patient was prescribed both TB treatment and ART). Risk ratios (RRs) and 95% confidence intervals (CIs) were used to identify factors associated with non-adherence.
  
  Results
  
  Of the 1,252 persons receiving concurrent treatment, 138 (11.0%) were not adherent. Non-adherent persons were more likely to have extrapulmonary TB (RR: 1.71, 95% CI: 1.12 to 2.60) and had not disclosed their HIV status (RR: 1.96, 95% CI: 1.96 to 3.76).
  
  Conclusions
  
  The majority of persons with TB/HIV were adherent to concurrent treatment. Close monitoring and support of persons with extrapulmonary TB and for persons who have not disclosed their HIV status may further improve adherence to concurrent TB and antiretroviral treatment.
  
  
• Subjects:
  Adult Anti-Retroviral Agents Antitubercular Agents Coinfection Demography Female HIV Infections Humans Male Medication Adherence Middle Aged Multivariate Analysis Tuberculosis

  More +
• Source:
  PLoS One. 11(7).
• Pubmed ID:
  27442440
• Pubmed Central ID:
  PMC4956242
• Document Type:
  Journal Article
• Name as Subject:
  United States. President's Emergency Plan For AIDS Relief (PEPFAR)
• Place as Subject:
  South Africa
• Volume:
  11
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:43899465011a90da8cd67d1e7994622db263417382251e39aa6ec9430d4abaef8492f99c9d37ad4947ff9fead6418100d06dd05e3e128f4b62880cb3fae1baa3
• Download URL:
  https://stacks.cdc.gov/view/cdc/40798/cdc_40798_DS1.pdf
• File Type:
  [PDF - 804.56 KB ]