HIV-positive patients treated for multidrug-resistant tuberculosis

http://www.ncbi.nlm.nih.gov/pubmed/22640448

Int J Tuberc Lung Dis. 2012 Mar;16(3):348-54.

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

Palacios E, Franke M, Muñoz M, Hurtado R, Dallman R, Chalco K, Guerra D, Mestanza L, Llaro K, Bonilla C, Sebastian J, Bayona J,Lygizos M, Anger H, Shin S.

Source

Socios En Salud, Sucursal Peru, Lima, Peru.

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.