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Programmatic treatment outcomes in HIV-infected and uninfected drug-resistant TB patients in Khayelitsha, South Africa.
Mohr, Erika; Cox, Vivian; Wilkinson, Lynne; Moyo, Sizulu; Hughes, Jennifer; Daniels, Johnny; Muller, Odelia; Cox, Helen.
Afiliação
  • Mohr E; Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa msfocb-khayelitsha-drtb-epi@brussels.msf.org.
  • Cox V; Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa.
  • Wilkinson L; Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa.
  • Moyo S; Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa.
  • Hughes J; Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa.
  • Daniels J; Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa.
  • Muller O; Médecins Sans Frontières (MSF), Khayelitsha, Cape Town, South Africa.
  • Cox H; University of Cape Town, Division of Medical Microbiology and Institute of Infectious Disease and Molecular Medicine, Cape Town, South Africa.
Trans R Soc Trop Med Hyg ; 109(7): 425-32, 2015 Jul.
Article em En | MEDLINE | ID: mdl-25979526
BACKGROUND: South Africa has high burdens of HIV, TB and drug-resistant TB (DR-TB, rifampicin-resistance). Treatment outcome data for HIV-infected versus uninfected patients is limited. We assessed the impact of HIV and other factors on DR-TB treatment success, time to culture conversion, loss-from-treatment and overall mortality after second-line treatment initiation. METHODS: A retrospective cohort analysis was conducted for patients initiated on DR-TB treatment from 2008 to 2012, within a community-based, decentralised programme in Khayelitsha, South Africa. RESULTS: Among 853 confirmed DR-TB patients initiating second-line treatment, 605 (70.9%) were HIV infected. HIV status did not impact on time to sputum culture conversion nor did it impact treatment success; 48.1% (259/539) and 45.9% (100/218), respectively (p=0.59). In a multivariate model, HIV was not associated with treatment success. Death during treatment was higher among HIV-infected patients, but overall mortality was not significantly higher. HIV-infected patients with CD4 <=100 cells/ml were significantly more likely to die after starting treatment. CONCLUSIONS: Response to DR-TB treatment did not differ with HIV infection in a programmatic setting with access to antiretroviral treatment (ART). Earlier ART initiation at a primary care level could reduce mortality among HIV-infected patients presenting with low CD4 counts.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções por HIV / Tuberculose Resistente a Múltiplos Medicamentos / Antituberculosos Tipo de estudo: Observational_studies / Prognostic_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged País como assunto: Africa Idioma: En Ano de publicação: 2015 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções por HIV / Tuberculose Resistente a Múltiplos Medicamentos / Antituberculosos Tipo de estudo: Observational_studies / Prognostic_studies Limite: Adolescent / Adult / Female / Humans / Male / Middle aged País como assunto: Africa Idioma: En Ano de publicação: 2015 Tipo de documento: Article