Timing of antiretroviral therapy in Cambodian hospital after diagnosis of tuberculosis: impact of revised WHO guidelines
Kimcheng Choun, Reaksmey Pe, Sopheak Thai, Natalie Lorent, Lutgarde Lynen & Johan van Griensven
Volume 91, Number 3, March 2013, 195-206
Table 4. Competing risk regression modelling of time from the diagnosis of tuberculosis to initiation of antiretroviral therapy (ART) among all individuals diagnosed with tuberculosis (n = 452), pre- and post-implementation of the 2010 WHO ART guidelines, Cambodia, December 2008 to November 2011
| Parameter | sHR (95% CI) | Adjusted sHRa (95% CI) | Adjusted sHR (LTFU = death) (95% CI) |
|---|---|---|---|
| Pre-implementation |
Ref |
Ref |
Ref |
| Post-implementation | |||
| Time (weeks) from tuberculosis diagnosis | |||
| < 2 | 0.75 (0.45–1.25) | 0.97 (0.57–1.66) | 0.76 (0.46–1.23) |
| 2–6 | 2.45 (1.79–3.65) | 2.60 (1.87–3.62) | 2.44 (1.79–3.33) |
| > 6 | 0.93 (0.59–1.47) | 1.08 (0.69–1.69) | 1.43 (0.92–2.22) |
| CD4+ cell count (cells/μL) at tuberculosis diagnosis | |||
| > 50 | Ref | Ref | Ref |
| ≤ 50 | 1.46 (1.11–1.91) | 1.44 (1.17–1.76) | 1.32 (1.07–1.63) |
| Missing | 0.59 (0.23–1.55) | 0.26 (0.10–0.66) | 0.13 (0.06–0.30) |
| Type of tuberculosis | |||
| Extrapulmonary | Ref | Ref | Ref |
| Smear-positive pulmonary | 1.20 (0.91–1.59) | 0.97 (0.73–1.29) | 0.87 (0.65–1.15) |
| Smear-negative pulmonary | 0.87 (0.61–1.22) | 0.76 (0.59–0.98) | 0.77 (0.60–1.00) |
| Enrolled in HIV care before tuberculosis diagnosis | |||
| No | Ref | Ref | Ref |
| Yes | 1.16 (0.89–1.52) | 1.31 (1.06–1.63) | 1.25 (1.00–1.59) |
CI, confidence interval; HIV, human immunodeficiency virus; LTFU, loss to follow-up; Ref, reference; sHR, subhazard ratio; WHO, World Health Organization.
a Starting from the full model, a stepwise selection process was followed. Covariates were retained in the model if their removal/inclusion induced a change of > 10% in the measure of effect of the main exposure or if they were significantly associated with the outcome in the adjusted analysis.