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Factors influencing delay in initiating antiretroviral therapy among HIV infected patients coinfected with tuberculosis
  1. D Chilton1,
  2. S G Edwards1,
  3. P Pellegrino1,
  4. R F Miller2
  1. 1
    The Mortimer Market Centre, Camden Primary Care Trust, London, UK
  2. 2
    Research Department of Infection and Population Health, Division of Population Health, Royal Free and University College London Medical School, University College London, London, UK
  1. Professor R F Miller, Research Department of Infection and Population Health, Division of Population Health, University College London, Mortimer Market Centre, off Capper Street, London WC1E 6JB, UK; rmiller{at}

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The optimum time to start antiretroviral therapy (ART) in a HIV infected patient receiving antituberculosis therapy (ATT) is unknown.1 2 Concurrent treatment of tuberculosis (TB) and HIV is complicated by poor adherence from high pill burden, overlapping toxicities, pharmacokinetic drug–drug interactions and risk of immune reconstitution inflammatory syndrome (IRIS).2 The risk of disease progression if ART is delayed has to be balanced against the risk of needing to discontinue treatment if ART is started soon after initiating ATT. We examined factors influencing delay in initiation of ART in patients taking ATT and compared our practice against British HIV Association (BHIVA) HIV/TB treatment guidelines.3

We retrospectively reviewed the case notes of coinfected ART naive patients attending a central …

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  • Competing interests: RFM is a member of the Editorial Advisory Board of the British Medical Journal, a member of the Editorial Board of BMJ Case Reports and is co-editor of Sexually Transmitted Infections, part of the BMJ Publishing Group.