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This combination regimen refers to the therapeutic strategy investigated in the PrOMPT (Presumptive TB Treatment in HIV-infected Patients Initiating ART) clinical trial, led by Prof. JMA Lange. The regimen involves the administration of a standard four-drug tuberculosis (TB) chemotherapy (rifampicin, isoniazid, pyrazinamide, and ethambutol) followed by the initiation of efavirenz-based antiretroviral therapy (ART), typically comprising efavirenz, lamivudine, and tenofovir. This strategy was designed to prevent early mortality in severely immunocompromised HIV-infected patients (CD4 < 50 cells/μl and BMI < 18 kg/m²) in sub-Saharan Africa, where undiagnosed TB is a leading cause of death during the first few months of ART. The trial aimed to determine if presumptive treatment for TB, regardless of a confirmed diagnosis, could reduce the high rates of early mortality observed in this vulnerable population.
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