Efficacy of an unsupervised 8-month rifampicin-containing regimen for the treatment of pulmonary tuberculosis in HIV-infected adults. Uganda-Case Western Reserve University Research Collaboration.

Abstract

SETTING:

National Tuberculosis Treatment Centre, Mulago Hospital, Kampala, Uganda.

OBJECTIVE:

To assess the efficacy of a daily, self-administered 8-month rifampicin-containing regimen for the treatment of pulmonary tuberculosis (TB) in human immunodeficiency virus (HIV) infected adults.

DESIGN:

Treatment outcomes in patients with pulmonary TB treated with a single 8-month regimen and followed in a prospective epidemiological study.

RESULTS:

Two hundred and sixty-five HIV-infected and 26 non-HIV-infected adults with initial episodes of pulmonary tuberculosis were treated with 2 months of daily isoniazid (INH), rifampicin (RMP), ethambutol and pyrazinamide followed by 6 months of daily INH + RMP. Median follow-up was 17.8 months. Ninety-five per cent of the HIV-infected and all of the non-HIV-infected patients who had sputum examined were sputum culture negative after 2 months of treatment. Twenty-two HIV-infected and no non-HIV-infected patients died during treatment. Relapse rates were 8.4% (5.9 per 100 person-years of observation [PYO], 95%CI 3.2-8.6) among HIV-infected patients and 4.5% (2.1/100 PYO, 95%CI 0-7.8) for non-HIV-infected patients. Adverse drug reactions occurred in 37% of the HIV-infected patients; most were minor and self-limiting.

CONCLUSION:

An 8-month RMP-containing regimen was well tolerated and effective in the treatment of HIV-infected adults with initial episodes of pulmonary TB. Relapse rates were similar to those reported with 6-month short-course regimens in HIV-infected individuals. Decisions about the duration of anti-tuberculosis treatment for HIV-infected adults must balance programme resources and the likelihood of poor compliance with longer regimens with the potential for a modest decrease in relapses with longer treatment.

• Authors: J L Johnson, A Okwera, P Nsubuga, J G Nakibali, C C Whalen, D Hom, M D Cave, Z H Yang, R D Mugerwa, J J Ellner
• Journal: The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease (Int J Tuberc Lung Dis) Vol. 4 Issue 11 Pg. 1032-40 (Nov 2000) ISSN: 1027-3719 [Print] France
• PMID: 11092715 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Antibiotics, Antitubercular
• Rifampin

Topics

• AIDS-Related Opportunistic Infections (drug therapy)
• Adult
• Antibiotics, Antitubercular (therapeutic use)
• Drug Therapy, Combination
• Female
• Humans
• Male
• Prospective Studies
• Rifampin (therapeutic use)
• Tuberculosis, Pulmonary (drug therapy)
• Uganda