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

نویسندگان

  • Max R. O’Donnell
  • Nesri Padayatchi
  • Charlotte Kvasnovsky
  • Lise Werner
  • Iqbal Master
  • C. Robert Horsburgh
چکیده

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.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Mediastinoscopy after negative endoscopic mediastinal nodal staging: can it be omitted?

References 1 World Health Organization. Companion Handbook to the WHO Guidelines for Programmatic Management of Drug Resistant Tuberculosis. WHO/HTM/TB/2014.11. Geneva, WHO, 2014. 2 Cox HS, Furin J, Mitnick CD, et al. The need to accelerate access to new drugs for multidrug-resistant tuberculosis. Bull World Health Organ 2015; 93: 491–497. 3 Isaakidis P, Cox HS, Varghese B, et al. Ambulatory mu...

متن کامل

Impact of resistance to first-line and injectable drugs on treatment outcomes in MDR-TB.

Recently, resistance to additional first-line and injectable drugs was reported to be an independent risk factor for adverse outcomes in multidrug-resistant (MDR) tuberculosis (TB) patients. The aim of the present study was to confirm these observations in MDR-TB patients without HIV infection. MDR-TB patients treated at a tertiary referral hospital in South Korea between January 1996 and Decem...

متن کامل

Emergence of Increased Resistance and Extensively Drug-Resistant Tuberculosis Despite Treatment Adherence, South Africa

We investigated the emergence and evolution of drug-resistant tuberculosis (TB) in an HIV co-infected population at a South African gold mine with a well-functioning TB control program. Of 128 patients with drug-resistant TB diagnosed during January 2003-November 2005, a total of 77 had multidrug-resistant (MDR) TB, 26 had pre-extensively drug-resistant TB (XDR TB), and 5 had XDR TB. Genotyping...

متن کامل

Linezolid for multidrug-resistant tuberculosis in HIV-infected and -uninfected patients.

Two recent systematic reviews found that treatment outcomes with regimens containing linezolid for complicated cases of multidrug-resistant (MDR) tuberculosis (TB) are equal to or better than those reported for uncomplicated MDR-TB [1, 2] and better than those reported among patients treated for extensively drug-resistant (XDR)-TB [3–6]. Existing data on treatment outcomes with linezolid for MD...

متن کامل

1697Prevalence and associated factors of infection with drug-resistant Mycobacterium tuberculosis in Thailand

Background. Drug-resistant Mycobacterium tuberculosis is one of the most serious forms of tuberculosis (TB). We sought to estimate the prevalence of resistance to anti-tuberculosis drugs and to identify associated factors. Methods. Culture positiveM. tuberculosis cases were identified from microbiological database. Clinical and laboratory data were retrieved retrospectively from January 1, 2010...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره 19  شماره 

صفحات  -

تاریخ انتشار 2013