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Human Immunodeficiency Virus Type 1 and tuberculosis co-infection in multinational resource limited settings: increased neurological dysfunction

Background. AIDS Clinical Trial Group 5199 compared neurological and neuropsychological test performance of human immunodeficiency virus type 1 (HIV-1)–infected participants in resource-limited settings treated with 3 World Health Organization–recommended antiretroviral (ART) regimens. We investigat...

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Published: 2019
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LEADER 00000njm a2000000a 4500
001 oai:repository.ui.edu.ng:123456789/13555
042 |a dc 
720 |a Robertson, K.  |e author 
720 |a Oladeji, B.  |e author 
720 |a Jiang, H.  |e author 
720 |a Kumwenda, J.  |e author 
720 |a Supparatpinyo, K.  |e author 
720 |a Campbell, T.  |e author 
720 |a Hakim, J.  |e author 
720 |a Tripathy, S.  |e author 
720 |a Hosseinipour, M.  |e author 
720 |a Marra, C. M.  |e author 
720 |a Kumarasamy, N.  |e author 
720 |a Evans, S.  |e author 
720 |a Vecchio, A.  |e author 
720 |a La Rosa, A.  |e author 
720 |a Santos, B.  |e author 
720 |a Silva, M. T.  |e author 
720 |a Montano, S.  |e author 
720 |a Kanyama, C.  |e author 
720 |a Firnhaber, C.  |e author 
720 |a Price, R.  |e author 
720 |a Marcus, C.  |e author 
720 |a Berzins, B.  |e author 
720 |a Masih, R.  |e author 
720 |a Lalloo, U.  |e author 
720 |a Sanne, I.  |e author 
720 |a Yosief, S.  |e author 
720 |a Walawander, A.  |e author 
720 |a Nair, A.  |e author 
720 |a Sacktor, N.  |e author 
720 |a Hall, C.  |e author 
720 |a AIDS Clinical Trials Group  |e author 
260 |c 2019 
520 |a Background. AIDS Clinical Trial Group 5199 compared neurological and neuropsychological test performance of human immunodeficiency virus type 1 (HIV-1)–infected participants in resource-limited settings treated with 3 World Health Organization–recommended antiretroviral (ART) regimens. We investigated the impact of tuberculosis (TB) on neurological and neuropsychological outcomes. Methods. Standardized neurological and neuropsychological examinations were administered every 24 weeks. Generalized estimating equation models assessed the association between TB and neurological/neuropsychological performance. Results. Characteristics of the 860 participants at baseline were as follows: 53% female, 49% African; median age, 34 years; CD4 count, 173 cells/μL; and plasma HIV-1 RNA, 5.0 log copies/mL. At baseline, there were 36 cases of pulmonary, 9 cases of extrapulmonary, and 1 case of central nervous system (CNS) TB. Over the 192 weeks of follow-up, there were 55 observations of pulmonary TB in 52 persons, 26 observations of extrapulmonary TB in 25 persons, and 3 observations of CNS TB in 2 persons. Prevalence of TB decreased with ART initiation and follow-up. Those with TB coinfection had significantly poorer performance on grooved pegboard (P < .001) and finger tapping nondominant hand (P < .01). TB was associated with diffuse CNS disease (P < .05). Furthermore, those with TB had 9.27 times (P < .001) higher odds of reporting decreased quality of life, and had 8.02 times (P = .0005) higher odds of loss of productivity. Conclusions. TB coinfection was associated with poorer neuropsychological functioning, particularly the fine motor skills, and had a substantial impact on functional ability and quality of life. 
024 8 |a 1537-6591 
024 8 |a ui_art_robertson_hiv-1_2019 
024 8 |a Clinical Infectious Diseases 68(10), pp. 1739–1746 
024 8 |a https://repository.ui.edu.ng/handle/123456789/13555 
653 |a HIV 
653 |a Tuberculosis 
653 |a Resource-limited 
653 |a Cognitive impairment 
653 |a Neuropsychological functioning 
245 0 0 |a Human Immunodeficiency Virus Type 1 and tuberculosis co-infection in multinational resource limited settings: increased neurological dysfunction