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dc.contributor.authorKevin R. Robertsonen_US
dc.contributor.authorBibilola Oladejien_US
dc.contributor.authorHongyu Jiangen_US
dc.contributor.authorJohnstone Kumwendaen_US
dc.contributor.authorKhuanchai Supparatpinyoen_US
dc.contributor.authorThomas B. Campbellen_US
dc.contributor.authorJames Hakimen_US
dc.contributor.authorSrikanth Tripathyen_US
dc.contributor.authorMina C. Hosseinipouren_US
dc.contributor.authorChristina M. Marraen_US
dc.contributor.authorNagalingeswaran Kumarasamyen_US
dc.contributor.authorScott Evansen_US
dc.contributor.authorAlyssa Vecchioen_US
dc.contributor.authorAlberto La Rosaen_US
dc.contributor.authorBreno Santosen_US
dc.contributor.authorMarcus T. Silvaen_US
dc.contributor.authorSylvia Montanoen_US
dc.contributor.authorCecilia Kanyamaen_US
dc.contributor.authorCindy Firnhaberen_US
dc.contributor.authorRichard Priceen_US
dc.contributor.authorCheryl Marcusen_US
dc.contributor.authorBaida Berzinsen_US
dc.contributor.authorReena Masihen_US
dc.contributor.authorUmesh Lallooen_US
dc.contributor.authorIan Sanneen_US
dc.contributor.authorSarah Yosiefen_US
dc.contributor.authorAnn Walawanderen_US
dc.contributor.authorAspara Nairen_US
dc.contributor.authorNed Sacktoren_US
dc.contributor.authorColin Hallen_US
dc.description.abstract© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. Background. AIDS Clinical Trial Group 5199 compared neurological and neuropsychological test performance of human immunodeficiency virus type 1 (HIV-1)-infected participants in resource-limited settings treated with 3 World Health Organization-recommended antiretroviral (ART) regimens. We investigated the impact of tuberculosis (TB) on neurological and neuropsychological outcomes. Methods. Standardized neurological and neuropsychological examinations were administered every 24 weeks. Generalized estimating equation models assessed the association between TB and neurological/neuropsychological performance. Results. Characteristics of the 860 participants at baseline were as follows: 53% female, 49% African; median age, 34 years; CD4 count, 173 cells/μL; and plasma HIV-1 RNA, 5.0 log copies/mL. At baseline, there were 36 cases of pulmonary, 9 cases of extrapulmonary, and 1 case of central nervous system (CNS) TB. Over the 192 weeks of follow-up, there were 55 observations of pulmonary TB in 52 persons, 26 observations of extrapulmonary TB in 25 persons, and 3 observations of CNS TB in 2 persons. Prevalence of TB decreased with ART initiation and follow-up. Those with TB coinfection had significantly poorer performance on grooved pegboard (P < .001) and fingertapping nondominant hand (P < .01). TB was associated with diffuse CNS disease (P < .05). Furthermore, those with TB had 9.27 times (P < .001) higher odds of reporting decreased quality of life, and had 8.02 times (P = .0005) higher odds of loss of productivity. Conclusions. TB coinfection was associated with poorer neuropsychological functioning, particularly the fine motor skills, and had a substantial impact on functional ability and quality of life.en_US
dc.titleHuman Immunodeficiency Virus Type 1 and Tuberculosis Coinfection in Multinational, Resource-limited Settings: Increased neurological dysfunctionen_US
article.title.sourcetitleClinical Infectious Diseasesen_US
article.volume68en_US Science &amp; Technology Research Foundation, Inc.en_US &amp; Scientific Systems, Inc.en_US of Zimbabween_US School of Public Healthen_US Oswaldo Cruzen_US University of North Carolina at Chapel Hillen_US of California, San Franciscoen_US of Washington, Seattleen_US of Colorado Health Sciences Centeren_USà Vita-Salute San Raffaeleen_US Universityen_US of Ibadanen_US Hopkins Universityen_US AIDS Research Institute Indiaen_US Mai Universityen_US Elizabethen_USón Civil Impacta Salud y Educaciónen_US Centre for AIDS Research and Educationen_US Conceicaoen_US
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