Operationalizing HIV Care in Africa

In an open-label, randomized, controlled trial, screening and pre-emptive treatment for cryptococcal infection plus early adherence support after ART initiation significantly improved 1-year survival.

Although expanded access to antiretroviral therapy (ART) in Africa has greatly improved survival, early mortality after ART initiation remains high. Cryptococcal infection and tuberculosis (TB) account for most of the early deaths, and cost-effective strategies are needed to improve outcomes. In an open-label, controlled study conducted in Tanzania and Zambia, researchers assessed one such strategy: screening for cryptococcal antigen (CrAg) before ART initiation (and treating those with positive results) together with community-based early ART adherence support.

HIV-infected adults with CD4 counts <200 cells/mm³ were randomized to receive standard care or enhanced care (adherence support plus serum CrAg screening). Participants testing CrAg-…

Reviewing Author

Charles B. Hicks, MD

Disclosures

Consultant / Advisory boardGilead Sciences; ViiV; Merck

RoyaltiesUpToDate, Inc.

Grant / Research supportNIH; Department of Health and Human Services

Charles B. Hicks, MD

Disclosures

Consultant / Advisory boardGilead Sciences; ViiV; Merck

RoyaltiesUpToDate, Inc.

Grant / Research supportNIH; Department of Health and Human Services

Operationalizing HIV Care in Africa

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Reviewing Author