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ACP Journal Club |20 March 2012

Earlier initiation of antiretroviral therapy after start of antituberculosis therapy reduced mortality in HIV

Santiago Moreno, MD

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Blanc FX, Sok T, Laureillard D, et al. Earlier versus later start of antiretroviral therapy in HIV-infected adults with tuberculosis. N Engl J Med. 2011;365:1471-81. 22010913

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Optimal timing of ART initiation in HIV-infected patients with TB is a challenge. Early initiation of ART has been intuitively preferred to prevent immunologic impairment and clinical deterioration. However, possible disadvantages of this approach include development of overlapping toxicities (e.g., elevated liver enzymes, rash, and gastrointestinal intolerance), increased incidence of IRIS, drug interactions, and a higher pill burden that could compromise adherence. Although initiation of ART after the induction period...
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Moreno S. Earlier initiation of antiretroviral therapy after start of antituberculosis therapy reduced mortality in HIV. Ann Intern Med. 2012;156:JC3–2. doi: 10.7326/0003-4819-156-6-201202210-02002

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Published: Ann Intern Med. 2012;156(6):JC3-2.

DOI: 10.7326/0003-4819-156-6-201202210-02002

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