Sputum culture reversion in longer treatments with bedaquiline, delamanid, and repurposed drugs for drug-resistant tuberculosis

Sputum culture reversion after conversion is an indicator of tuberculosis (TB) treatment failure. We analyze data from the endTB multi-country prospective observational cohort (NCT03259269) to estimate the frequency (primary endpoint) among individuals receiving a longer (18-to-20 month) regimen for...

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Vydáno v:Nature communications Ročník 15; číslo 1; s. 3927 - 7
Hlavní autoři: Kho, Sooyeon, Seung, Kwonjune J., Huerga, Helena, Bastard, Mathieu, Khan, Palwasha Y., Mitnick, Carole D., Rich, Michael L., Islam, Shirajul, Zhizhilashvili, Dali, Yeghiazaryan, Lusine, Nikolenko, Elena Nikolaevna, Zarli, Khin, Adnan, Sana, Salahuddin, Naseem, Ahmed, Saman, Vargas, Zully Haydee Ruíz, Bekele, Amsalu, Shaimerdenova, Aiman, Tamirat, Meseret, Gelin, Alain, Vilbrun, Stalz Charles, Hewison, Catherine, Khan, Uzma, Franke, Molly
Médium: Journal Article
Jazyk:angličtina
Vydáno: London Nature Publishing Group UK 09.05.2024
Nature Publishing Group
Nature Portfolio
Témata:
692/308/174
692/699/255/1856
Adult
Antitubercular Agents - pharmacology
Antitubercular Agents - therapeutic use
Body mass index
Body size
Comorbidity
Diarylquinolines - pharmacology
Diarylquinolines - therapeutic use
Drug Repositioning
Drug resistance
Drugs
Female
Hepatitis
Hepatitis C
Humanities and Social Sciences
Humans
Male
Middle Aged
Monitoring
multidisciplinary
Mycobacterium tuberculosis - drug effects
Nitroimidazoles - pharmacology
Nitroimidazoles - therapeutic use
Oxazoles - therapeutic use
Prospective Studies
Regression analysis
Rifampin
Science
Science (multidisciplinary)
Sputum
Sputum - microbiology
Telemedicine
Tuberculosis
Tuberculosis, Multidrug-Resistant - drug therapy
Tuberculosis, Multidrug-Resistant - microbiology
ISSN:2041-1723, 2041-1723
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Shrnutí:Sputum culture reversion after conversion is an indicator of tuberculosis (TB) treatment failure. We analyze data from the endTB multi-country prospective observational cohort (NCT03259269) to estimate the frequency (primary endpoint) among individuals receiving a longer (18-to-20 month) regimen for multidrug- or rifampicin-resistant (MDR/RR) TB who experienced culture conversion. We also conduct Cox proportional hazard regression analyses to identify factors associated with reversion, including comorbidities, previous treatment, cavitary disease at conversion, low body mass index (BMI) at conversion, time to conversion, and number of likely-effective drugs. Of 1,286 patients, 54 (4.2%) experienced reversion, a median of 173 days (97-306) after conversion. Cavitary disease, BMI < 18.5, hepatitis C, prior treatment with second-line drugs, and longer time to initial culture conversion were positively associated with reversion. Reversion was uncommon. Those with cavitary disease, low BMI, hepatitis C, prior treatment with second-line drugs, and in whom culture conversion is delayed may benefit from close monitoring following conversion. In patients with drug-resistant tuberculosis who receive treatment with new and repurposed drugs, indicators of advanced disease and delayed conversion were associated with an increased risk of reversion. These factors may be targets for close monitoring.
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ISSN:2041-1723
2041-1723
DOI:10.1038/s41467-024-48077-8