Use este identificador para citar ou linkar para este item:
https://www.arca.fiocruz.br/handle/icict/61937
Tipo de documento
ArtigoDireito Autoral
Acesso restrito
Data de embargo
2030-12-31
Coleções
- INI - Artigos de Periódicos [3460]
Metadata
Mostrar registro completo
VIROLOGIC RESPONSE TO ANTIRETROVIRAL THERAPY IN PEOPLE WITH HIV AND TUBERCULOSIS IN HIGH TUBERCULOSIS BURDEN COUNTRIES
Autor(es)
Afiliação
University of Bordeaux. National Institute for Health and Medical Research. Research Institute for Sustainable Development. Bordeaux Population Health Centre. Bordeaux, France / Infectious Diseases Department. AP-HP-Hôpital Saint-Louis Lariboisière. Paris, France.
University of Bordeaux. National Institute for Health and Medical Research. Research Institute for Sustainable Development. Bordeaux Population Health Centre. Bordeaux, France.
Hospital Universitário Professor Edgar Santos. Laboratório de Pesquisa em Doenças Infecciosas. Salvador, BA, Brasil.
Programme PACCI/ANRS Research Center / Centre de Prise en Charge de Recherche et de Formation. CePReF-Aconda-VS. Abidjan, Cote D'Ivoire / Département de Dermatologie et d'Infectiologie. UFR des Sciences Médicales. Université Félix Houphouët Boigny, Abidjan, Cote d'Ivoire.
Instituto Nacional de Saúde. Marracuene, Mozambique.
Department of Infectious and Tropical Diseases. Nimes University Hospital. Nimes / Research Unit 1058. Pathogenesis and Control Chronical Infections, INSERM. French Blood Center. University of Montpellier. Montpellier, France.
Pham Ngoc Thach Hospital. Ho Chi Minh City, Vietnam.
Fundação Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Programme PACCI/ANRS Research Center / Département de Dermatologie et d'Infectiologie. UFR des Sciences Médicales. Université Félix Houphouët Boigny, Abidjan, Cote d'Ivoire.
Virology department. APHP-Hôpital Saint-Louis / INSERM U944 / Université Paris. Cité, Paris.
Infectious Diseases Department, AP-HP-Hôpital Saint-Louis Lariboisière, Paris, France / INSERM U944 / Université Paris. Cité, Paris.
University Bordeaux, INSERM. Institut Bergonié, Bordeaux / INRIA SISTM team, Talence / CHU de Bordeaux. Service d'information médicale, INSERM. Institut Bergonié. Bordeaux, France.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Rio de Janeiro, RJ, Brazil.
University of Bordeaux. National Institute for Health and Medical Research. Research Institute for Sustainable Development. Bordeaux Population Health Centre. Bordeaux, France.
University of Bordeaux. National Institute for Health and Medical Research. Research Institute for Sustainable Development. Bordeaux Population Health Centre. Bordeaux, France.
Hospital Universitário Professor Edgar Santos. Laboratório de Pesquisa em Doenças Infecciosas. Salvador, BA, Brasil.
Programme PACCI/ANRS Research Center / Centre de Prise en Charge de Recherche et de Formation. CePReF-Aconda-VS. Abidjan, Cote D'Ivoire / Département de Dermatologie et d'Infectiologie. UFR des Sciences Médicales. Université Félix Houphouët Boigny, Abidjan, Cote d'Ivoire.
Instituto Nacional de Saúde. Marracuene, Mozambique.
Department of Infectious and Tropical Diseases. Nimes University Hospital. Nimes / Research Unit 1058. Pathogenesis and Control Chronical Infections, INSERM. French Blood Center. University of Montpellier. Montpellier, France.
Pham Ngoc Thach Hospital. Ho Chi Minh City, Vietnam.
Fundação Oswaldo Cruz. Laboratório de AIDS e Imunologia Molecular. Rio de Janeiro, RJ, Brasil.
Programme PACCI/ANRS Research Center / Département de Dermatologie et d'Infectiologie. UFR des Sciences Médicales. Université Félix Houphouët Boigny, Abidjan, Cote d'Ivoire.
Virology department. APHP-Hôpital Saint-Louis / INSERM U944 / Université Paris. Cité, Paris.
Infectious Diseases Department, AP-HP-Hôpital Saint-Louis Lariboisière, Paris, France / INSERM U944 / Université Paris. Cité, Paris.
University Bordeaux, INSERM. Institut Bergonié, Bordeaux / INRIA SISTM team, Talence / CHU de Bordeaux. Service d'information médicale, INSERM. Institut Bergonié. Bordeaux, France.
Oswaldo Cruz Foundation. Evandro Chagas National Institute of Infectious Diseases. Rio de Janeiro, RJ, Brazil.
University of Bordeaux. National Institute for Health and Medical Research. Research Institute for Sustainable Development. Bordeaux Population Health Centre. Bordeaux, France.
Resumo em Inglês
Objective: We sought to compare virologic outcomes on antiretroviral therapy (ART) between people with HIV (PWH) also treated for tuberculosis in the different countries who participated to two randomized trials. Design: Pooled analysis of two randomized clinical trials. Methods: In the phase II Reflate TB and phase III Reflate TB2 trials conducted in Brazil, Côte d'Ivoire, Mozambique and Vietnam, ART-naïve PWH treated for tuberculosis were randomized to receive raltegravir or efavirenz. We assessed country differences in baseline characteristic using Wilcoxon tests and chi-square, or Fisher's exact test. We used logistic regression to analyze determinants of virologic success, defined as week-48 plasma HIV-1 RNA <50 copies/ml. Results: Of 550 participants (140 from Brazil, 170 from Côte d'Ivoire, 129 from Mozambique and 111 from Vietnam) with median baseline HIV-1 RNA of 5.4 log 10 copies/ml, 362 (65.8%) achieved virologic success at week 48. Virologic success rates were: 105/140 (75.0%) in Brazil, 99/170 (58.2%) in Côte d'Ivoire, 84/129 (65.1%) in Mozambique and 74/111 (66.7%) in Vietnam ( P = 0.0233). Baseline HIV-1 RNA, but not the country, was independently associated with virologic success: baseline HIV-1 RNA ≥500 000 copies/ml (reference), HIV RNA <100 000 copies/ml odds ratio 3.12 [95% confidence interval (CI) 1.94; 5.01] and HIV-1 RNA 100 000-499 999 copies/ml odds ratio: 1.80 (95% CI 1.19; 2.73). Overall, 177/277 (63.9%) patients treated with raltegravir and 185/273 (67.9%) patients treated with efavirenz had a plasma HIV-1 RNA <50 copies/ml at week 48. Conclusions: Virologic response to antiretroviral therapy in PWH with TB varied across countries but was mainly driven by levels of pretreatment HIV-1 RNA.
Compartilhar