Predictors of Prolonged TB Treatment in a Dutch Outpatient Setting

Boveneind-Vrubleuskaya, Natasha van’t; Daskapan, Alper; Kosterink, Jos G. W.; Werf, Tjip S. van der; Hof, Susan van den; Alffenaar, Jan‐Willem C.

doi:10.1371/journal.pone.0166030

Cited by 7 publications

(5 citation statements)

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“…The patients with risk factors, such as presence of cavitation on the initial chest radiograph, having no radiographic improvement after 2 months of treatment, and having a positive AFS after 2 months of treatment, were reported to have prolonged treatment duration [11,12]. Thus, the patients with successful treatment outcomes were classified into a non-risk factor group (n = 72) and a risk factor group (n = 30; included 12 patients with presence of cavitation on the initial chest radiograph, 14 patients having no radiographic improvement after 2 months of treatment, and 4 patients having a positive AFS after 2 months of treatment).…”

Section: Classification Groups In Patients With Successful Treatment ...mentioning

confidence: 99%

Using TBAg/PHA Ratio for Monitoring TB Treatment: A Prospective Multicenter Study

Wang

Liu

et al. 2022

JCM

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The way to monitor tuberculosis (TB) treatment is extremely lacking in clinical practice. The aim of the study is to assess the role of the TBAg/PHA ratio in the treatment monitoring of TB. TB patients were followed up for 6 months and serial T-SPOT.TB (T-SPOT) assays were performed. In patients with successful treatment outcomes, the ESAT-6 sfc, CFP-10 sfc, and TBAg/PHA ratio all showed a decreased trend after the initiation of treatment. Conversely, PHA sfc showed an increased trend after 2 months of treatment. However, these indicators had moderate performance in distinguishing between before and after 6 months of treatment, and the AUC ranged from 0.702 to 0.839. Notably, the TBAg/PHA ratio in patients without risk factors was of important value in differentiation between before and after treatment. The optimal AUC of TBAg/PHA ratio reached up to 0.890. Patients with unsuccessful treatment outcomes showed persistently high levels of TBAg/PHA ratio. The TBAg/PHA ratio in patients after 6 months of treatment showed a certain potential in distinguishing between patients with successful and unsuccessful treatment outcomes. A further calculation of the TBAg/PHA ratio in T-SPOT assay has potential value in the treatment monitoring of TB, but further confirmation is needed.

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Section: Classification Groups In Patients With Successful Treatment ...mentioning

confidence: 99%

Using TBAg/PHA Ratio for Monitoring TB Treatment: A Prospective Multicenter Study

Wang

Liu

et al. 2022

JCM

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“…The hollow-fibre infection model and murine model conducted with the four FLDs showed that their effectiveness is best reflected by the area under the concentration-time curve (AUC)/minimum inhibitory concentration (MIC) ratio [9,[11][12][13]. Notably, high PK variability and inadequate TB drug exposure are undesirable as high drug concentrations could lead to toxicity, while low drug exposure predisposes to prolonged treatment, treatment failure, relapse, and development of drug resistance [9,[14][15][16][17]. Several factors are known to cause interindividual PK variability, including body weight [18], sex [18,19], pharmacogenomics [20,21] and comorbid conditions such as diabetes mellitus [19].…”

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confidence: 99%

A Systematic Review on the Effect of HIV Infection on the Pharmacokinetics of First-Line Tuberculosis Drugs

et al. 2018

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Introduction Contrasting findings have been published regarding the effect of human immunodeficiency virus (HIV) on tuberculosis (TB) drug pharmacokinetics (PK). Objectives The aim of this systematic review was to investigate the effect of HIV infection on the PK of the first-line TB drugs (FLDs) rifampicin, isoniazid, pyrazinamide and ethambutol by assessing all published literature. Methods Searches were performed in MEDLINE (through PubMed) and EMBASE to find original studies evaluating the effect of HIV infection on the PK of FLDs. The included studies were assessed for bias and clinical relevance. PK data were extracted to provide insight into the difference of FLD PK between HIV-positive and HIV-negative TB patients. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and its protocol was registered at PROSPERO (registration number CRD42017067250). Results Overall, 27 studies were eligible for inclusion. The available studies provide a heterogeneous dataset from which consistent results could not be obtained. In both HIV-positive and HIV-negative TB groups, rifampicin (13 of 15) and ethambutol (4 of 8) peak concentration (C max) often did not achieve the minimum reference values. More than half of the studies (11 of 20) that included both HIV-positive and HIV-negative TB groups showed statistically significantly altered FLD area under the concentration-time curve and/or C max for at least one FLD. Conclusions HIV infection may be one of several factors that reduce FLD exposure. We could not make general recommendations with respect to the role of dosing. There is a need for consistent and homogeneous studies to be conducted.

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“…3 ATLI has a significant role in diminishing treatment effectiveness by increasing patient morbidity and mortality and disrupting therapy adherence. 4,5 As an independent predictor of prolonged TB treatment, 6 the high occurrence of ATLI results in discontinuation of therapy and potentially treatment failure. In adults, various factors, such as advanced age, female sex, malnutrition, HIV/ AIDS, preexistent liver disease (eg, hepatitis B/C infections), alcohol intoxication, hepatotoxic comedications and genetics, are reported to be associated with higher risk to develop ATLI.…”

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confidence: 99%