HIV-infected presumptive tuberculosis patients without tuberculosis: How many are eligible for antiretroviral therapy in Karnataka, India?

Ajay M.V. Kumar; Anil Singarajipura; Balaji Naik; Deepak K. Guddemane; Yogesh Patel; Suresh Shastri; Sunil Kumar; Rajesh Deshmukh; B.B. Rewari; Anthony David Harries

doi:10.1016/j.jegh.2015.12.002

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Volume 7, Issue 1, March 2017, Pages 11 - 19

HIV-infected presumptive tuberculosis patients without tuberculosis: How many are eligible for antiretroviral therapy in Karnataka, India?

Authors

Ajay M.V. Kumar^a^{, *}^,akumar@theunion.org, Anil Singarajipura^b, Balaji Naik^c, Deepak K. Guddemane^c, Yogesh Patel^c, Suresh Shastri^b, Sunil Kumar^d^{, e}, Rajesh Deshmukh^e, B.B. Rewari^e, Anthony David Harries^f^{, g}

^aInternational Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Regional Office, New Delhi, India

^bState TB Cell, Directorate of Health Services, Bangalore, Karnataka, India

^cWorld Health Organization Country Office, New Delhi, India

^dKarnataka State AIDS Prevention Society, Bangalore, Karnataka, India

^eNational AIDS Control Organization, Ministry of Health and Family Welfare, New Delhi, India

^fInternational Union Against Tuberculosis and Lung Disease (The Union), Paris, France

^gLondon School of Hygiene and Tropical Medicine, London, United Kingdom

^*Corresponding author at: International Union Against Tuberculosis and Lung Disease, The Union South-East Asia Office, C-6, Qutub Institutional Area, New Delhi, 110016 India.

Corresponding Author

Ajay M.V. Kumarakumar@theunion.org

Received 5 October 2015, Revised 21 December 2015, Accepted 26 December 2015, Available Online 25 January 2016.

DOI: 10.1016/j.jegh.2015.12.002 How to use a DOI?
Keywords: ART eligibility; ART initiation criteria; HIV-infected presumptive TB patients; HIV-infected TB suspects; Operational research; WHO 2013 ART guidelines
Abstract: For certain subgroups within people living with the human immunodeficiency virus (HIV) [active tuberculosis (TB), pregnant women, children <5 years old, and serodiscordant couples], the World Health Organization recommends antiretroviral therapy (ART) irrespective of CD4 count. Another subgroup which has received increased attention is “HIV-infected presumptive TB patients without TB”. In this study, we assess the proportion of HIV-infected presumptive TB patients eligible for ART in Karnataka State (population 60 million), India. This was a cross-sectional analysis of data of HIV-infected presumptive TB patients diagnosed in May 2015 abstracted from national TB and HIV program records. Of 42,585 presumptive TB patients, 28,964 (68%) were tested for HIV and 2262 (8%) were HIV positive. Of the latter, 377 (17%) had active TB. Of 1885 “presumptive TB patients without active TB”, 1100 (58%) were already receiving ART. Of the remaining 785 who were not receiving ART, 617 (79%) were assessed for ART eligibility and of those, 548 (89%) were eligible for ART. About 90% of “HIV-infected presumptive TB patients without TB” were eligible for ART. This evidence supports a public health approach of starting all “HIV-infected presumptive TB patients without TB” on ART irrespective of CD4 count in line with global thinking about ‘test and treat’.
Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Journal: Journal of Epidemiology and Global Health
Volume-Issue: 7 - 1
Pages: 11 - 19
Publication Date: 2016/01/25
ISSN (Online): 2210-6014
ISSN (Print): 2210-6006
DOI: 10.1016/j.jegh.2015.12.002 How to use a DOI?
Open Access: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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ris enw bib

TY  - JOUR
AU  - Ajay M.V. Kumar
AU  - Anil Singarajipura
AU  - Balaji Naik
AU  - Deepak K. Guddemane
AU  - Yogesh Patel
AU  - Suresh Shastri
AU  - Sunil Kumar
AU  - Rajesh Deshmukh
AU  - B.B. Rewari
AU  - Anthony David Harries
PY  - 2016
DA  - 2016/01/25
TI  - HIV-infected presumptive tuberculosis patients without tuberculosis: How many are eligible for antiretroviral therapy in Karnataka, India?
JO  - Journal of Epidemiology and Global Health
SP  - 11
EP  - 19
VL  - 7
IS  - 1
SN  - 2210-6014
UR  - https://doi.org/10.1016/j.jegh.2015.12.002
DO  - 10.1016/j.jegh.2015.12.002
ID  - Kumar2016
ER  -

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