Sputum conversion at the end of intensive phase of Category-1 regimen in the treatment of pulmonary tuberculosis patients with diabetes mellitus or HIV infection: An analysis of risk factors.

Abstract

BACKGROUND & OBJECTIVE:

New smear-positive pulmonary tuberculosis (PTB) patients in the Revised National Tuberculosis Control Programme (RNTCP) are treated with a 6-month short-course chemotherapy (SCC) regimen irrespective of co-morbid conditions. We undertook this retrospective analysis to compare sputum conversion rates (smear, culture) at the end of intensive phase (IP) of Category-1 regimen among patients admitted to concurrent controlled clinical trials: pulmonary tuberculosis alone (PTB) or with type 2 diabetes mellitus (DM-TB) or HIV infection (HIV-TB), and to identify the risk factors influencing sputum conversion.

METHODS:

In this retrospective analysis sputum conversion rates at the end of intensive phase (IP) in three concurrent studies undertaken among PTB, DM-TB and HIV-TB patients, during 1998 - 2002 at the Tuberculosis Research Centre (TRC), Chennai, were compared. Sputum smears were examined by fluorescent microscopy. HIV infected patients did not receive anti-retroviral treatment (ART). Patients with DM were treated with oral hypoglycaemic drugs or insulin (sc).

RESULTS:

The study population included 98, 92 and 88 patients in the PTB, DM-TB and HIV-TB studies. At the end of IP the smear conversion (58, 61, and 62%) and culture conversion (86, 88 and 92%) rates were similar in the three groups respectively. The variables associated with lack of sputum smear or culture conversion were age >45 yr, higher pre-treatment smear and culture grading, and extent of the radiographic involvement.

INTERPRETATION & CONCLUSION:

Our findings confirm that the current policy of the control programme to treat all pulmonary TB patients with or with out co-morbid conditions with Category-I regimen appears to be appropriate.

• Authors: V V Banu Rekha, Rani Balasubramanian, Soumya Swaminathan, Rajeswari Ramachandran, Fathima Rahman, V Sundaram, K Thyagarajan, N Selvakumar, A R Adhilakshmi, Sheik Iliayas, P R Narayanan
• Journal: The Indian journal of medical research (Indian J Med Res) Vol. 126 Issue 5 Pg. 452-8 (Nov 2007) ISSN: 0971-5916 [Print] India
• PMID: 18160750 (Publication Type: Journal Article)

Chemical References

• Antitubercular Agents

Topics

• Adolescent
• Adult
• Aged
• Antitubercular Agents (therapeutic use)
• Comorbidity
• Diabetes Mellitus, Type 2 (physiopathology)
• Female
• HIV Infections (physiopathology)
• Humans
• India
• Male
• Middle Aged
• Retrospective Studies
• Risk Factors
• Sputum (microbiology)
• Treatment Outcome
• Tuberculosis, Pulmonary (drug therapy)