Low rates of recurrence after successful treatment of multidrug-resistant tuberculosis in Tomsk, Russia.

SETTING: Tomsk, Russia, where multidrug-resistant tuberculosis (MDR-TB) is prevalent. OBJECTIVES: To report rates of recurrence following successful treatment of MDR-TB in a program providing individualized treatment regimens designed according to the current global standard of care. DESIGN: A retrospective cohort study of 408 adults successfully treated for pulmonary MDR-TB from 10 September 2000 to 1 November 2004, and followed for up to 6 years post-treatment. We used Poisson regression with generalized estimating equations to assess whether recurrence rates changed significantly with time. RESULTS: We analyzed 399 (97.5%) patients with at least one follow-up visit (15 850 person-months of observation [PMO]). Baseline resistance to second-line drugs was common (65.2%); 398 patients (99.7%) were human immunodeficiency virus (HIV) negative. In the first year of post-treatment follow-up, there were six episodes of recurrence (1.4/1000 PMO, 95%CI 0.5-3.0). After the first post-treatment year, there were 21 episodes of recurrence (1.8/1000 PMO, 95%CI 1.1-2.8). The rate did not change significantly with time. CONCLUSION: Individualized regimens designed according to the current global standard of care achieved low rates of MDR-TB recurrence among non-HIV-infected persons treated in a programmatic setting.

LPO and apoptosis during pulmonary tuberculosis.

LPO and apoptosis in blood mononuclear cells were studied in patients with pulmonary tuberculosis before and during treatment with standard chemotherapeutics. Pulmonary tuberculosis was accompanied by LPO activation and intensification of apoptosis in lymphocytes and monocytes. These changes were observed before and after the course of intensive care. The intensity of lipid peroxidation retuned to normal, while activity of apoptosis remained high after therapy.