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Co-trimoxazole prophylaxis is associated with reduced risk of incident tuberculosis in participants in the Swiss HIV Cohort Study.

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Author Hasse Barbara, Walker A Sarah, Fehr Jan, Furrer Hansjakob, Hoffmann Matthias, Battegay Manuel, Calmy Alexandra, Fellay Jacques, Di Benedetto Caroline, Weber Rainer, Ledergerber Bruno,
Project Swiss HIV Cohort Study (SHCS)
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Original article (peer-reviewed)

Journal Antimicrobial agents and chemotherapy
Volume (Issue) 58(4)
Page(s) 2363 - 8
Title of proceedings Antimicrobial agents and chemotherapy
DOI 10.1128/aac.01868-13

Open Access

URL http://doi.org/10.1128/AAC.01868-1
Type of Open Access Publisher (Gold Open Access)

Abstract

Co-trimoxazole reduces mortality in HIV-infected adults with tuberculosis (TB), and in vitro data suggest potential antimycobacterial activity of co-trimoxazole. We aimed to evaluate whether prophylaxis with co-trimoxazole is associated with a decreased risk of incident TB in Swiss HIV Cohort Study (SHCS) participants. We determined the incidence of TB per 1,000 person-years from January 1992 to December 2012. Rates were analyzed separately in participants with current or no previous antiretroviral treatment (ART) using Poisson regression adjusted for CD4 cell count, sex, region of origin, injection drug use, and age. A total of 13,431 cohort participants contributed 107,549 person-years of follow-up: 182 patients had incident TB-132 (73%) before and 50 (27%) after ART initiation. The multivariable incidence rate ratios for cumulative co-trimoxazole exposure per year for persons with no previous ART and current ART were 0.70 (95% confidence interval [CI], 0.55 to 0.89) and 0.87 (95% CI, 0.74 to 1.0), respectively. Co-trimoxazole may prevent the development of TB among HIV-positive persons, especially among those with no previous ART.
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