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Bioethicists Assail a Celebrated TB/HIV Treatment Trial

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Science  14 May 2010:
Vol. 328, Issue 5980, pp. 799-801
DOI: 10.1126/science.328.5980.799

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A heralded clinical study in South Africa that assessed the best treatment strategy for people infected with HIV who are receiving drugs for tuberculosis should never have been done, argue two bioethicists in an online posting published 5 May by the Hastings Center, a bioethics research institute. The study, Starting Antiretroviral Therapy at Three Points in Tuberculosis, began in June 2005 and was stopped in September 2008 after an interim analysis found that people who delayed starting anti-HIV drugs until they completed a 6-to-8-month course of anti-TB medication had twice the risk of death. The prominent research group that ran the 642-person study immediately reported the findings, which led the World Health Organization to strengthen its guidelines.