Enhanced Prophylaxis plus Antiretroviral Therapy for Advanced HIV Infection in Africa

High mortality is associated with initiation of antiretroviral therapy for HIV. In this report from sub-Saharan Africa, enhanced prophylaxis with isoniazid, fluconazole, azithromycin, and albendazole was associated with decreased mortality at 24 and 48 weeks.

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Bibliographic Details
Published in:	The New England journal of medicine Vol. 377; no. 3; pp. 233 - 245
Main Authors:	Hakim, James, Musiime, Victor, Szubert, Alex J, Mallewa, Jane, Siika, Abraham, Agutu, Clara, Walker, Simon, Pett, Sarah L, Bwakura-Dangarembizi, Mutsa, Lugemwa, Abbas, Kaunda, Symon, Karoney, Mercy, Musoro, Godfrey, Kabahenda, Sheila, Nathoo, Kusum, Maitland, Kathryn, Griffiths, Anna, Thomason, Margaret J, Kityo, Cissy, Mugyenyi, Peter, Prendergast, Andrew J, Walker, A. Sarah, Gibb, Diana M
Format:	Journal Article
Language:	English
Published:	United States Massachusetts Medical Society 20-07-2017
Subjects:	Adolescent Adult Africa South of the Sahara - epidemiology Aged AIDS-Related Opportunistic Infections - prevention & control Albendazole Anti-Infective Agents - adverse effects Anti-Infective Agents - therapeutic use Anti-Retroviral Agents - adverse effects Anti-Retroviral Agents - therapeutic use Antibiotics Antifungal agents Antiretroviral drugs Antiretroviral therapy Azithromycin Candidiasis CD4 antigen CD4 Lymphocyte Count Child Clinical trials Drug therapy Drug Therapy, Combination Female Fluconazole Fungal infections HIV HIV Infections - drug therapy HIV Infections - mortality Human immunodeficiency virus Humans Immunosuppression Isoniazid Isoniazid - therapeutic use Kaplan-Meier Estimate Male Medical research Middle Aged Mortality Preventive medicine Prophylaxis Pyridoxine Pyridoxine - therapeutic use Sulfamethoxazole Trimethoprim Trimethoprim, Sulfamethoxazole Drug Combination - therapeutic use Trimethoprim-sulfamethoxazole Tuberculosis Young Adult Zimbabwe Uganda Kenya Malawi
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Summary:	High mortality is associated with initiation of antiretroviral therapy for HIV. In this report from sub-Saharan Africa, enhanced prophylaxis with isoniazid, fluconazole, azithromycin, and albendazole was associated with decreased mortality at 24 and 48 weeks.
Bibliography:	A complete list of the members of the Reduction of Early Mortality in HIV-Infected Adults and Children Starting Antiretroviral Therapy (REALITY) trial team is provided in the Supplementary Appendix, available at NEJM.org.
ISSN:	0028-4793 1533-4406
DOI:	10.1056/NEJMoa1615822