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Methods & Results

Integration of HIV and TB services results in earlier and more prioritised ART initiation in Uganda. Sabine Hermans 1,2,3 , Barbara Castelnuovo 1 , Andrew Kambugu 1 , Joep Lange 2 , Andy Hoepelman 3 , Yuka Manabe 1,4

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Methods & Results

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  1. Integration of HIV and TB services results in earlier and more prioritised ART initiation in Uganda. Sabine Hermans1,2,3, Barbara Castelnuovo1, Andrew Kambugu1, Joep Lange2, Andy Hoepelman3, Yuka Manabe1,4 1Infectious Diseases Institute, Makerere University College of Health Sciences, Uganda 2Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, the Netherlands 3Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, the Netherlands 4Johns Hopkins University School of Medicine, Baltimore, United States of America

  2. Methods & Results • Outdoor “One-Stop Shop” TB/HIV clinic: • TB diagnosis & treatment • HIV treatment • Analysis of ART initiation in TB patients in 2007 (pre) versus 2009 (post) Fewer ART naïve TB patients were initiated on ART in 2009 versus 2007 (56% and 66%, P=0.03), but this decrease was only in patients with higher CD4 counts. More patients were started on ART during TB treatment (94% versus 81%, P=0.001). Median time to ART initiation: 101 (IQR 63, 204) to 44 (IQR 21, 105) days (P=0.01).

  3. Results: Timing of ART & Outcomes P=0.318 P=0.128 P<0.001 Outcomes: not started on ART * • Survival and retention improved: • 52% in 2009 versus 33% in 2007 in the patients not initiated on ART (P=0.015) • 83% versus 80% in the patients who were started ART (P=0.514) *P=0.011

  4. IDI TB working group: Immaculate Ariko Catherine Katabira Peter Mbidde Isaac Lwanga Elly Kyolaba Jennifer Kisakye IDI Senior Management Team: Alex Coutinho IDI Data Management Team: Victor Afayo Olivia Nampewo Rosette Bukirwa Yale summer students 2007 and 2009: Betsy Lee, Ambika Bushan, Ryan Park, Nikia McFadden, Abraar Karan Sponsors INTERACT Programme European Union Acknowledgements

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