Treatment Outcomes for Extensively Drug-Resistant Tuberculosis and HIV Co-infection

High mortality rates have been reported for patients co-infected with extensively drug-resistant tuberculosis (XDR-TB) and HIV, but treatment outcomes have not been reported. We report treatment outcomes for adult XDR TB patients in KwaZulu-Natal Province, South Africa. Initial data were obtained re...

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Veröffentlicht in:Emerging infectious diseases Jg. 19; H. 3; S. 416 - 424
Hauptverfasser: O’Donnell, Max R., Padayatchi, Nesri, Kvasnovsky, Charlotte, Werner, Lise, Master, Iqbal, Horsburgh, C. Robert
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States U.S. National Center for Infectious Diseases 01.03.2013
Centers for Disease Control and Prevention
Schlagworte:
Adolescent
Adult
Antitubercular Agents - therapeutic use
bacteria
Care and treatment
Coinfection - drug therapy
Coinfection - mortality
Comorbidity
Cycloserine - therapeutic use
Drug Therapy, Combination
Ethambutol - therapeutic use
Ethionamide - therapeutic use
extensively drug-resistant tuberculosis
Extensively Drug-Resistant Tuberculosis - drug therapy
Extensively Drug-Resistant Tuberculosis - mortality
Female
HIV
HIV infection
HIV Infections - drug therapy
HIV Infections - mortality
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Patient outcomes
Pyrazinamide - therapeutic use
Retrospective Studies
Treatment Outcome
Tuberculosis
tuberculosis and other mycobacteria
Tuberculosis, Pulmonary - drug therapy
Tuberculosis, Pulmonary - mortality
viruses
XDR TB
Young Adult
United States
viruses
HIV
bacteria
co-infection
treatment outcomes
XDR TB
extensively drug-resistant tuberculosis
tuberculosis and other mycobacteria
South Africa
ISSN:1080-6040, 1080-6059, 1080-6059
Online-Zugang:Volltext
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Zusammenfassung:High mortality rates have been reported for patients co-infected with extensively drug-resistant tuberculosis (XDR-TB) and HIV, but treatment outcomes have not been reported. We report treatment outcomes for adult XDR TB patients in KwaZulu-Natal Province, South Africa. Initial data were obtained retrospectively, and outcomes were obtained prospectively during 24 months of treatment. A total of 114 XDR TB patients were treated (median 6 drugs, range 3-9 drugs); 82 (73%) were HIV positive and 50 (61%) were receiving antiretroviral therapy. After receiving treatment for 24 months, 48 (42%) of 114 patients died, 25 (22%) were cured or successfully completed treatment, 19 (17%) withdrew from the study, and 22 (19%) showed treatment failure. A higher number of deaths occurred among HIV-positive patients not receiving antiretroviral therapy and among patients who did not show sputum culture conversion. Culture conversion was a major predictor of survival but was poorly predictive (51%) of successful treatment outcome.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1080-6040
1080-6059
1080-6059
DOI:10.3201/eid1903.120998