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Although evidence of its effectiveness is thin, directly observed therapy (DOT) is employed commonly in treating patients with tuberculosis worldwide. DOT has also been suggested for highly active antiretroviral therapy (HAART), but concerns about patient autonomy and cost are greater for lifelong HIV therapy than for short-term treatment of TB. To assess the effectiveness of DOT in treating HIV-positive patients, researchers conducted a meta-analysis of 12 trials that included a total of 1862 patients who were receiving HAART. Viral suppression to an undetectable level was the primary endpoint.
Included studies were from the U.S. and four African countries, with treatment and follow-up periods ranging from 3 to 24 months. In the combined an…