CD4+ cell count stratification to guide tuberculosis preventive therapy for people living with HIV.

ABSTRACT:

Objectives

In 2018, Brazilian guidelines changed to recommend tuberculosis (TB) preventive therapy for all people with HIV and a CD4 cell count 350 cells/μl or less, but only for those with a positive tuberculin skin test (TST) if CD4 cell count is than 350 cells/μl. We determined the potential effectiveness of CD4-based guidelines for TB testing and preventive therapy.

Design

Secondary analysis of the stepped-wedge, cluster-randomized THRio trial for isoniazid preventive therapy (IPT).

Methods

We analyzed data from 4114 newly registered patients with HIV in 29 clinics followed until TB diagnosis, death, or administrative censoring. We compared incidence rates of TB and TB/death between CD4, TST, IPT, and antiretroviral therapy categories.

Results

Initial CD4 c

SUBMITTER: Chaisson LH 

PROVIDER: S-EPMC7112158 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature