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Initiating antiretroviral therapy (ART) together with tuberculosis (TB) therapy could reduce mortality risk among coinfected patients by 55%, according to interim findings from a large clinical trial in South Africa. Historically, ART has been delayed in many coinfected patients until after the completion of TB therapy because of concerns about drug–drug interactions, high pill burden, overlapping drug toxicities, and immune reconstitution inflammatory syndrome.
The SAPIT trial was designed to determine the optimal timing of ART initiation in conjunction with TB treatment. Enrollment took place between June 2005 and July 2008. A total of 645 coinfected patients were randomized to one of three treatment arms:
Early integrated treatment: Patien…