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http://ir.mu.ac.ke:8080/jspui/handle/123456789/6258
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DC Field | Value | Language |
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dc.contributor.author | Petta, Sarah L | - |
dc.contributor.author | Spyerb, Moira | - |
dc.contributor.author | Haddowa, Lewis J | - |
dc.contributor.author | Nhema, Ruth | - |
dc.contributor.author | Benjamine, Laura A | - |
dc.contributor.author | Najjukag, Grace | - |
dc.contributor.author | Bilima, Sithembile | - |
dc.contributor.author | Daudi, Ibrahim | - |
dc.contributor.author | Musorod, Godfrey | - |
dc.contributor.author | Kitabalwag, Juliet | - |
dc.contributor.author | Selemani, George | - |
dc.contributor.author | Kandiei, Salome | - |
dc.contributor.author | Corneliusi, K Magut | - |
dc.contributor.author | Katemba, Chrispus | - |
dc.contributor.author | Berkley, Jay A | - |
dc.contributor.author | Hassan, Amin S | - |
dc.contributor.author | Kityog, Cissy | - |
dc.contributor.author | Hakim, James | - |
dc.contributor.author | Heyderman, Robert S | - |
dc.contributor.author | Gibbb, Diana M | - |
dc.contributor.author | Walker, Ann S | - |
dc.date.accessioned | 2022-04-20T09:04:41Z | - |
dc.date.available | 2022-04-20T09:04:41Z | - |
dc.date.issued | 2020-04-25 | - |
dc.identifier.uri | http://ir.mu.ac.ke:8080/jspui/handle/123456789/6258 | - |
dc.description.abstract | Objectives: To assess baseline prevalence of cryptococcal antigen (CrAg) positivity; and its contribution to reductions in all-cause mortality, deaths from cryptococcus and unknown causes, and new cryptococcal disease in the REALITY trial. Design: Retrospective CrAg testing of baseline and week-4 plasma samples in all 1805 African adults/children with CD4þ cell count less than 100 cells/ml starting antiretrovi ral therapy who were randomized to receive 12-week enhanced-prophylaxis (flucona zole 100 mg/day, azithromycin, isoniazid, cotrimoxazole) vs. standard-prophylaxis (cotrimoxazole). Methods: Proportional hazards models were used to estimate the relative impact of enhanced-prophylaxis vs. standard-cotrimoxazole on all, cryptococcal and unknown deaths, and new cryptococcal disease, through 24 weeks, by baseline CrAg positivity. Results: Excluding 24 (1.4%) participants with active/prior cryptococcal disease at enrolment (all treated for cryptococcal disease), 133/1781 (7.5%) participants were CrAg-positive. By 24 weeks, 105 standard-cotrimoxazole vs. 78 enhanced-prophylaxis participants died. Of nine standard-cotrimoxazole and three enhanced-prophylaxis cryptococcal deaths, seven and two, respectively, were CrAg-positive at baseline. Among deaths of unknown cause, only 1/46 standard-cotrimoxazole and 1/28 enhanced-prophylaxis were CrAg-positive at baseline. There was no evidence that relative reductions in new cryptococcal disease associated with enhanced-prophylaxis varied between baseline CrAg-positives [hazard-ratio ¼ 0.36 (95% confidence interval 0.13–0.98), incidence 19.5 vs. 56.5/100 person-years] and CrAg-negatives [hazard ratio ¼ 0.33 (0.03–3.14), incidence 0.3 vs. 0.9/100 person-years; Pheterogeneity¼ 0.95]; nor for all deaths, cryptococcal deaths or unknown deaths. | en_US |
dc.language.iso | en | en_US |
dc.publisher | Wolter Klower | en_US |
dc.subject | Cryptococcus | en_US |
dc.subject | HIV | en_US |
dc.subject | Late presentation | en_US |
dc.subject | Prophylaxis | en_US |
dc.title | Benefits of enhanced infection prophylaxis at antiretroviral therapy initiation by cryptococcal antigen status | en_US |
dc.type | Article | en_US |
Appears in Collections: | School of Medicine |
Files in This Item:
File | Description | Size | Format | |
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MAGUT 2.pdf | 357.94 kB | Adobe PDF | View/Open |
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