Treatments: Drug Schedule Improves Survival Rate of Those With AIDS and Tuberculosis

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via Khmer NZ

By DONALD G. McNEIL Jr.

Published: August 9, 2010

People who are near death from a combination of tuberculosis and AIDS are more likely to survive if they get immediate TB treatment, followed two weeks later by antiretroviral drugs for AIDS, doctors are reporting.

Several AIDS specialists said the research, supported by the French and American governments and done over five years in five hospitals in Cambodia, was some of the most important revealed at the international AIDS meeting in Vienna last month. A quarter of all deaths among people with AIDS are caused by tuberculosis.

People with both advanced TB and AIDS present doctors with a dilemma: reviving a depressed immune system with anti-AIDS drugs sometimes touches off such a strong inflammatory response against the tuberculosis in the lungs that the patient is killed. So doctors typically start TB treatment first, followed by AIDS treatment. But when to start the second has largely been guesswork.

The trial, nicknamed Camelia, for “Cambodian Early vs. Late Introduction of Antiretrovirals,” found that among 661 patients, those who started taking AIDS drugs two weeks later were 34 percent more likely to survive than those who waited eight weeks before starting.

“We imagine these findings will make a major impact on mortality due to TB and H.I.V. co-infection globally,” said Prof. Eng Huot, the Cambodian secretary of state for health.

Dr. Wafaa el-Sadr, an AIDS expert at Columbia University, said the treatment had saved lives, and added, “It’s another piece of evidence of the positive effects of H.I.V. treatment.”