APPROPRIATE PRESCRIPTION OF PROTEASE INHIBITORS AND HIV TREATMENT OUTCOMES IN HIV-TUBERCULOSIS CO-INFECTED PATIENTS ON RIFAMPICIN IN URBAN HIV CLINICS IN UGANDA.

Abstract

We aimed to determine how emerging evidence over the past decade informed how Ugandan HIV clinicians prescribed protease inhibitors (PIs) in HIV patients on rifampicin based TB treatment and how this affected HIV treatment outcomes. We enrolled HIV patients aged ≥13 years treated with rifampicin based TB treatment while on protease inhibitors between 2013 and 2018 from fourteen public HIV clinics. Of the 602 patients who were on both PIs and rifampicin, 103 patients (17.1% (95% CI: 14.3-20.34) received an appropriate PI prescription (double dose LPV/r). There were no significant differences in the two year mortality, loss to follow up and one year post TB treatment virologic failure rates between patients that had double dose LPV/r and those that did not (4.8% vs. 5.7%, 23.8% vs. 18.9%, P= 0.318 and 31.6% vs. 30.7%, P= 0.471 respectively). However, more patients on double dose LPV/r had missed ART days (35.9% vs 21%, P= 0.001). We conclude that despite availability of clinical evidence, double dosing LPV/r in patients receiving rifampicin based TB treatment is low in Uganda’s public HIV clinics but this does not seem to affect patient survival and viral suppression.