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Lack of Weight Gain During the First 2 Months of Treatment and Human Immunodeficiency Virus Independently Predict Unsuccessful Treatment Outcomes in Tuberculosis.
- Source :
- Journal of Infectious Diseases; 5/1/2020, Vol. 221 Issue 9, p1416-1424, 9p
- Publication Year :
- 2020
-
Abstract
- <bold>Background: </bold>Weight change may inform tuberculosis treatment response, but its predictive power may be confounded by human immunodeficiency virus (HIV).<bold>Methods: </bold>We prospectively followed up adults with culture-confirmed, drug-susceptible, pulmonary tuberculosis receiving standard 4-drug therapy (isoniazid, rifampin, pyrazinamide, and ethambutol) in Brazil. We examined median weight change 2 months after treatment initiation by HIV status, using quantile regression, and unsuccessful tuberculosis treatment outcome (treatment failure, tuberculosis recurrence, or death) by HIV and weight change status, using Cox regression.<bold>Results: </bold>Among 547 participants, 102 (19%) were HIV positive, and 35 (6%) had an unsuccessful outcome. After adjustment for confounders, persons living with HIV (PLWH) gained a median of 1.3 kg (95% confidence interval [CI], -2.8 to .1) less than HIV-negative individuals during the first 2 months of tuberculosis treatment. PLWH were at increased risk of an unsuccessful outcome (adjusted hazard ratio, 4.8; 95% CI, 2.1-10.9). Weight change was independently associated with outcome, with risk of unsuccessful outcome decreasing by 12% (95% CI, .81%-.95%) per 1-kg increase.<bold>Conclusions: </bold>PLWH gained less weight during the first 2 months of tuberculosis treatment, and lack of weight gain and HIV independently predicted unsuccessful tuberculosis treatment outcomes. Weight, an easily collected biomarker, may identify patients who would benefit from alternative treatment strategies. [ABSTRACT FROM AUTHOR]
- Subjects :
- HIV
WEIGHT gain
DIRECTLY observed therapy
TUBERCULOSIS
TREATMENT effectiveness
QUANTILE regression
DRUG therapy for tuberculosis
TUBERCULOSIS complications
RESEARCH
PYRAZINAMIDE
TIME
RESEARCH methodology
HIV seroconversion
EVALUATION research
MEDICAL cooperation
ISONIAZID
AMINES
COMPARATIVE studies
ANTITUBERCULAR agents
RESEARCH funding
RIFAMPIN
PROPORTIONAL hazards models
LONGITUDINAL method
Subjects
Details
- Language :
- English
- ISSN :
- 00221899
- Volume :
- 221
- Issue :
- 9
- Database :
- Complementary Index
- Journal :
- Journal of Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 142636753
- Full Text :
- https://doi.org/10.1093/infdis/jiz595