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Public Health Action. 2016 Mar 21;6(1):8-14. doi: 10.5588/pha.16.0011.

Collaborative activities and treatment outcomes in patients with HIV-associated tuberculosis in Viet Nam.

Author information

1
Viet Nam National Tuberculosis Control Programme/National Lung Hospital, Hanoi, Viet Nam.
2
International Union Against Tuberculosis and Lung Disease (The Union) South-East Asia Regional Office, New Delhi, India.
3
Viet Nam National Tuberculosis Control Programme/National Lung Hospital, Hanoi, Viet Nam ; The Union, Paris, France.
4
The Union, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK.

Abstract

in English, French, Spanish

SETTING:

The National Tuberculosis (TB) Programme in Viet Nam and Ho Chi Minh City (HCMC).

OBJECTIVES:

To determine 1) at national level between 2011 and 2013, the relationship between human immunodeficiency virus (HIV) testing, uptake of TB-HIV interventions and adverse treatment outcomes among TB-HIV patients; and 2) in HCMC in 2013, patient characteristics associated with adverse outcomes.

DESIGN:

An ecological study reviewing aggregate nationwide data and a retrospective cohort review in HCMC.

RESULTS:

Nationwide, from 2011 to 2013, HIV testing increased in TB patients from 58% to 68% and antiretroviral therapy (ART) increased in TB-HIV patients from 54% to 63%. Adverse treatment outcomes in TB-HIV patients increased from 24% to 27%, largely due to transfer out (5-9% increase) and death. The Northern and Highland regions showed poor uptake of TB-HIV interventions. In HCMC, 303 (27%) of 1110 TB-HIV patients had adverse outcomes, with higher risks observed in those with previously treated TB, those diagnosed as HIV-positive before TB onset and those never placed on cotrimoxazole or ART.

CONCLUSION:

Despite improving HIV testing rates and TB-HIV interventions, adverse outcomes in TB-HIV patients remain at about 26%. Characteristics predicting higher risk of adverse outcomes must be addressed if Viet Nam wishes to end the TB epidemic by 2030.

KEYWORDS:

SORT IT; adverse treatment outcomes; antiretroviral therapy; cotrimoxazole preventive therapy; operational research

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