HIV-positive patients treated for multidrug-resistant tuberculosis: clinical outcomes in the HAART era.

Abstract

SETTING:

Multidrug-resistant tuberculosis (MDR-TB) and the human immunodeficiency virus (HIV) pose two of the greatest threats to global tuberculosis (TB) control. Given expanding global access to antiretroviral therapy (ART) and second-line TB drugs, more data are needed on experiences treating MDR-TB and HIV co-infection in resource-poor settings.

OBJECTIVE:

To describe the clinical characteristics, management, outcomes, and factors associated with survival among HIV-positive individuals receiving treatment for MDR-TB.

DESIGN:

This was a retrospective case series of 52 HIV-positive individuals receiving treatment for MDR-TB in Lima, Peru. We used Cox proportional hazards regression models to identify risk factors for mortality.

RESULTS:

A total of 31 (57%) of the cohort died on treatment, with the majority of deaths due to MDR-TB. Low baseline weight predicted a three-fold increased rate of death (aHR 3.1, 95%CI 1.5-6.7), while individuals receiving highly active ART experienced a significantly lower rate of death compared to those who were not (aHR 0.4, 95%CI 0.2-0.9).

CONCLUSION:

Early ART is likely a key component of effective MDR-TB management in co-infected individuals.

• Authors: E Palacios, M Franke, M Muñoz, R Hurtado, R Dallman, K Chalco, D Guerra, L Mestanza, K Llaro, C Bonilla, J Sebastian, J Bayona, M Lygizos, M Lyzigos, H Anger, S Shin
• 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. 16 Issue 3 Pg. 348-54 ( 2012) ISSN: 1815-7920 [Electronic] France
• PMID: 22640448 (Publication Type: Journal Article)

Chemical References

• Anti-HIV Agents
• Antitubercular Agents

Topics

• Adult
• Anti-HIV Agents (administration & dosage, therapeutic use)
• Antiretroviral Therapy, Highly Active (methods)
• Antitubercular Agents (supply & distribution, therapeutic use)
• Female
• HIV Infections (complications, drug therapy, epidemiology)
• Health Services Accessibility
• Humans
• Male
• Peru (epidemiology)
• Proportional Hazards Models
• Regression Analysis
• Retrospective Studies
• Time Factors
• Treatment Outcome
• Tuberculosis, Multidrug-Resistant (complications, drug therapy, epidemiology)
• Young Adult