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Outcomes of HIV-infected versus HIV-non-infected patients treated for drug-resistance tuberculosis: Multicenter cohort study
- Source :
- PLoS ONE, PLoS ONE, Vol 13, Iss 3, p e0193491 (2018)
- Publication Year :
- 2018
- Publisher :
- Public Library of Science (PLoS), 2018.
-
Abstract
- Background The emergence of resistance to anti-tuberculosis (DR-TB) drugs and the HIV epidemic represent a serious threat for reducing the global burden of TB. Although data on HIV-negative DR-TB treatment outcomes are well published, few data on DR-TB outcomes among HIV co-infected people is available despite the great public health importance. Methods We retrospectively reported and compared the DR-TB treatment outcomes of HIV-positive and HIV-negative patients treated with an individualized regimen based on WHO guidelines in seven countries: Abkhazia, Armenia, Colombia, Kenya, Kyrgyzstan, Swaziland and Uzbekistan. Results Of the 1,369 patients started DRTB treatment, 809 (59.1%) were multi-drug resistant (MDR-TB) and 418 (30.5%) were HIV-positive. HIV-positive patients were mainly from African countries (90.1%) while HIV-negative originated from Former Soviet Union (FSU) countries. Despite a higher case fatality rate (19.0% vs 9.4%), HIV-positive MDR-TB patients had a 10% higher success rate than HIV-negative patients (64.0% vs 53.2%, p = 0.007). No difference in treatment success was found among polydrug-resistant (PDR-TB) patients. Overall, lost to follow-up rate was much higher among HIV-negative (22.0% vs. 8.4%). Older age and not receiving ART were the only factors associated with unfavorable treatment outcome among HIV-positive patients. Conclusions As already known for HIV-negative patients, success rate of DR-TB HIV-positive patients remains low and requires more effective DR-TB regimen using new drugs also suitable to HIV-infected patients on ART. The study also confirms the need of ART introduction in HIV co-infected patients.
- Subjects :
- RNA viruses
Bacterial Diseases
Male
0301 basic medicine
Epidemiology
Antitubercular Agents
lcsh:Medicine
HIV Infections
Pathology and Laboratory Medicine
0302 clinical medicine
Immunodeficiency Viruses
Risk Factors
Tuberculosis, Multidrug-Resistant
Case fatality rate
Medicine and Health Sciences
Medicine
Public and Occupational Health
030212 general & internal medicine
lcsh:Science
Multidisciplinary
Pharmaceutics
Coinfection
Multi-Drug-Resistant Tuberculosis
Mortality rate
Multi-drug-resistant tuberculosis
virus diseases
Middle Aged
Vaccination and Immunization
Infectious Diseases
Treatment Outcome
Medical Microbiology
HIV epidemiology
Viral Pathogens
Viruses
Asia, Central
Female
Pathogens
Research Article
Cohort study
Adult
medicine.medical_specialty
Tuberculosis
Death Rates
Immunology
030106 microbiology
Antiretroviral Therapy
Colombia
Microbiology
03 medical and health sciences
Pharmacotherapy
Population Metrics
Drug Therapy
Antiviral Therapy
Microbial Control
Internal medicine
Retroviruses
Humans
Microbial Pathogens
Retrospective Studies
Pharmacology
Population Biology
business.industry
lcsh:R
Lentivirus
Organisms
Biology and Life Sciences
HIV
Retrospective cohort study
Tropical Diseases
medicine.disease
Survival Analysis
Transcaucasia
Regimen
Antibiotic Resistance
Africa
lcsh:Q
Antimicrobial Resistance
Preventive Medicine
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- PLOS ONE
- Accession number :
- edsair.doi.dedup.....45ab583e65bd1133592b6e1f724b0edc