Effects of Cotrimoxazole on Hematologic Parameters in HIV-Infected Adults in a Community-Based Clinic in Entebbe, Uganda

Watera, Christine; Todd, Jim; Mutonyi, Gertrude; Miiro, George; Mpendo, Juliet; Hughes, Peter J.; Nakiyingi‐Miiro, Jessica; Whitworth, Jimmy; Grosskurth, Heiner

doi:10.1097/qai.0b013e3181170c47

Cited by 7 publications

(6 citation statements)

References 8 publications

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“…12 In HIV-infected adults with a CD4 cell count of at least 500 cells, CPT had no effect on hemoglobin. 32 The most applicable data come from a recent study of the effects of nevirapine and CPT in infants, where no increased risk of grade 3 or greater anemia was found. 33 …”

Section: Discussionmentioning

confidence: 99%

Effects of Cotrimoxazole Prophylactic Treatment on Adverse Health Outcomes Among HIV-exposed, Uninfected Infants

Dow

Kayira

Hudgens

et al. 2012

Pediatric Infectious Disease Journal

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Background The World Health Organization guidelines recommend cotrimoxazole prophylactic treatment (CPT) for all HIV-exposed infants from age 6 weeks to the cessation of breastfeeding and the exclusion of HIV infection. There are limited data about the effects of CPT among this population of infants. We examined the effects of CPT on adverse health outcomes among HIV-exposed infants during the first 36 weeks of life by using data from the Breastfeeding, Antiretrovirals, and Nutrition (BAN) study, a large clinical trial of antiretroviral drugs given to the mother or infant for prevention of HIV transmission during breastfeeding. Methods For the analysis, we assigned a status of CPT-exposed to infants who were participating in the study after the CPT program started. We estimated unadjusted and adjusted hazard ratios (HRs) for the effect of CPT status on time to incident malaria, severe illness or death, anemia, and weight-for-age Z score < −2.0. Participation in the study was limited to focus exclusively on HIV-exposed, uninfected infants. Results The HR for the effect of CPT on incident malaria was 0.35 (95% confidence interval [CI]: 0.21, 0.57) during the first 10 weeks of CPT exposure, and 0.93 (95% CI: 0.67, 1.29) for the remaining 20 weeks. CPT was not associated with the other outcomes examined. Conclusions CPT offered temporary protection against malaria among HIV-exposed, uninfected infants. However, CPT offered no protection against anemia, low weight for age, or the collapsed outcome of severe illness or death.

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Section: Discussionmentioning

confidence: 99%

Effects of Cotrimoxazole Prophylactic Treatment on Adverse Health Outcomes Among HIV-exposed, Uninfected Infants

Dow

Kayira

Hudgens

et al. 2012

Pediatric Infectious Disease Journal

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“…More research is needed to assess the potential, long‐term, harmful effects from the interaction between some HAART drugs and cotrimoxazole (Moh et al. 2005, Watera et al. 2007), and to provide guidelines as to when cotrimoxazole prophylaxis can be discontinued safely among immuno‐competent patients receiving HAART in resource‐limited countries.…”

Section: Discussionmentioning

confidence: 99%

Reduced morbidity and mortality in the first year after initiating highly active anti‐retroviral therapy (HAART) among Ugandan adults

Miiro

Todd

Mpendo

et al. 2009

Tropical Med Int Health

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Summaryobjective To evaluate the effect of highly active anti-retroviral therapy (HAART) and cotrimoxazole prophylaxis on morbidity after HAART eligibility.methods Between 1999 and 2006, we collected morbidity data from a community-based cohort of HAART-eligible patients, comparing patients initiating HAART and those non-HAART. Patients aged 15 years or older visited the clinic every 6 months and when ill. Baseline data on patients' characteristics, WHO stage, haemoglobin and CD4+ T-cell counts, along with follow-up data on morbidity (new, recurrent and drug-related), were collected for the first year after initiating HAART or becoming HAART-eligible. We estimated the overall effect of HAART on morbidity; adjusted for the effect of cotrimoxazole prophylaxis by Mantel-Haenszel methods. A negative binomial regression model was used to assess rate ratios (RR) after adjustment for other confounders, including cotrimoxazole.results A total of 219 HAART patients (median age 37 years; 73% women; 82% using cotrimoxazole prophylaxis, median haemoglobin 11.7 g ⁄ dl and median CD4+ 131 cells ⁄ ll) experienced 94 events in 127 person-years. 616 non-HAART patients (median age 33 years; 70% women; 26% using cotrimoxazole prophylaxis, median haemoglobin 11.2 g ⁄ dl and median CD4+ 130 cells ⁄ ll) experienced 862 events in 474 person-years. The overall morbidity during the first year of HAART was 80% lower than among non-HAART patients (adjusted RR = 0.20, 95% CI: 0.12-0.34). Cotrimoxazole prophylaxis also reduced morbidity (adjusted RR = 0.65, 95% CI: 0.45-0.94).conclusion These results confirm the reduction in morbidity due to HAART, and the additional protection of cotrimoxazole prophylaxis.keywords highly active anti-retroviral therapy, cotrimoxazole prophylaxis, morbidity, adverse events

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“…The Entebbe cohort was established by MRC/UVRI in 1994 to conduct epidemiological and clinical studies relating to HIV/AIDS. Further details about the open population cohort and the Entebbe cohort have been previously described (28–30). …”

Section: Methodsmentioning

confidence: 99%

Health, wellbeing, and disability among older people infected or affected by HIV in Uganda and South Africa

Nyirenda

Newell

Mugisha

et al. 2013

Global Health Action

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ObjectiveTo describe and compare the health status, emotional wellbeing, and functional status of older people in Uganda and South Africa who are HIV infected or affected by HIV in their families.MethodsData came from the general population cohort and Entebbe cohort of the Medical Research Council/Uganda Virus Research Institute, and from the Africa Centre Demographic Information System through cross-sectional surveys in 2009/10 using instruments adapted from the World Health Organization (WHO) Study on Global Ageing and adult health (SAGE). Analysis was based on 932 people aged 50 years or older (510 Uganda, 422 South Africa).ResultsParticipants in South Africa were slightly younger (median age − 60 years in South Africa, 63 in Uganda), and more were currently married, had no formal education, were not working, and were residing in a rural area. Adjusting for socio-demographic factors, older people in South Africa were significantly less likely to have good functional ability [adjusted odds ratio (aOR) 0.72, 95% CI 0.53–0.98] than those in Uganda, but were more likely to be in good subjective wellbeing (aOR 2.15, 95% CI 1.60–2.90). South Africans were more likely to be obese (aOR 5.26, 95% CI 3.46–8.00) or to be diagnosed with hypertension (aOR 2.77, 95% CI 2.06–3.73).Discussion and conclusionsWhile older people’s health problems are similar in the two countries, marked socio-demographic differences influence the extent to which older people are affected by poorer health. It is therefore imperative when designing policies to improve the health and wellbeing of older people in sub-Saharan Africa that the region is not treated as a homogenous entity.

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Effects of Cotrimoxazole on Hematologic Parameters in HIV-Infected Adults in a Community-Based Clinic in Entebbe, Uganda

Cited by 7 publications

References 8 publications

Effects of Cotrimoxazole Prophylactic Treatment on Adverse Health Outcomes Among HIV-exposed, Uninfected Infants

Effects of Cotrimoxazole Prophylactic Treatment on Adverse Health Outcomes Among HIV-exposed, Uninfected Infants

Reduced morbidity and mortality in the first year after initiating highly active anti‐retroviral therapy (HAART) among Ugandan adults

Health, wellbeing, and disability among older people infected or affected by HIV in Uganda and South Africa

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