Risk factors of multidrug-resistant tuberculosis: A global systematic review and meta-analysis

Pradipta, Ivan Surya; Forsman, Lina Davies; Bruchfeld, Judith; Hak, Eelko; Alffenaar, Jan-Willem

doi:10.1016/j.jinf.2018.10.004

Cited by 133 publications

(123 citation statements)

References 38 publications

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“…The efficacy of anti-TB treatment is of utmost importance to prevent the risk of selection and transmission of Mycobacterium tuberculosis resistant strains in the high-risk group of people living with HIV. 19 In this study, we observed that genetic variants in genes encoding for proteins implicated in the metabolism and transport may moderately influence the pharmacokinetics, efficacy, and tolerability of drugs used for treating HIV/TB co infection. If confirmed in studies with a larger sample size and in different settings, these observations may accelerate development of individually tailored treatments even in limited-resource countries.…”

Section: Discussionmentioning

confidence: 92%

“…Globally, treatment of patients co‐infected with HIV/TB is complicated by drug‐drug interactions, pill burden, adverse events, and poorer outcomes. The efficacy of anti‐TB treatment is of utmost importance to prevent the risk of selection and transmission of Mycobacterium tuberculosis resistant strains in the high‐risk group of people living with HIV …”

Section: Discussionmentioning

confidence: 99%

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The Influence of Pharmacogenetic Variants in HIV/Tuberculosis Coinfected Patients in Uganda in the SOUTH Study

Calcagno

Cusato

Sekaggya-Wiltshire

et al. 2019

Clin Pharma and Therapeutics

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Unsatisfactory treatment outcomes have been reported in patients coinfected with HIV/tuberculosis (TB). The aim of this study was to assess the influence of single‐nucleotide polymorphisms (SNPs) in genes encoding for proteins involved in antitubercular drug disposition or effect. A pharmacogenetic study was conducted in Kampala, Uganda, where all analysis was performed. The impact of SNPs on antitubercular drug exposure, adverse events, and treatment outcomes was evaluated in patients coinfected with HIV/TB receiving treatments for both conditions. In 221 participants, N‐acetyltransferase 2 (NAT2; rs1799930), solute carrier organic anion transporter family member 1B1 (SLCO1B1; rs4149032), and pregnane X receptor (PXR; rs2472677) variants affected isoniazid exposure in multivariate analysis. Most patients were deemed cured (163; 73.8%), yet PXR 63396TT carriers had a higher probability of death (P = 0.007) and of worsening peripheral neuropathy (P = 0.018). In this exploratory study in Ugandan patients coinfected with HIV/TB, genetic variants in PXR, SLCO1B1, and NAT2 were moderately associated with isoniazid exposure, whereas PXR 63396TT carriers showed worse outcomes.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

The Influence of Pharmacogenetic Variants in HIV/Tuberculosis Coinfected Patients in Uganda in the SOUTH Study

Calcagno

Cusato

Sekaggya-Wiltshire

et al. 2019

Clin Pharma and Therapeutics

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“…Multidrugresistant tuberculosis (MDR-TB) is the major part of drug-resistant tuberculosis [3], and its trends are an important reference to the strategies of TB control. MDR-TB is de ned as the Mycobacterium tuberculosis that is resistant to isoniazid and rifampicin, which is strongly related to previous TB disease and its treatment [4,5]. In the 1990s, MDR-TB outbreaks were reported in the USA and Europe [6,7], and global surveillance of antituberculosis drug resistance was considered urgent and necessary.…”

Section: Introductionmentioning

confidence: 99%

Trends in burden of multidrug-resistant tuberculosis in countries, regions, and worldwide from 1990 to 2017: results from the Global Burden of Disease Study

Deng²,

Liang

et al. 2020

Preprint

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Background This study aimed to estimate the trends of multidrug-resistant tuberculosis (MDR-TB), which can be used to inform health strategies.Methods Data were collected from the Global Burden of Disease Study 2017. The estimated annual percentage change (EAPCs) were calculated to assess the trends of MDR-TB burden from 1990 to 2017.Results Globally, the ASR of MDR-TB burden including incidence, prevalence, death and disability-adjusted life years (DALYs) had pronounced increasing trends from 1990 to 1999, with the EAPCs were 17.63(95% confidence interval [CI]: 10.77 to 24.92), 17.57(95%CI: 11.51 to 23.95), 21.21(95%CI:15.96 to 26.69), and 21.90(95%CI: 16.55 to 27.50), respectively. Particularly, the largest increasing trends were seen in areas and countries of low and low-middle sociodemographic index (SDI). However, the trends in incidence, prevalence, death and DALYs of MDR-TB decreased globally from 2000 to 2017, with the respective EAPCs were −1.37(95%CI: −1.62 to −1.12), −1.32(95%CI: −1.38 to −1.26), −3.30(95%CI: −3.56 to −3.04) and −3.32(95%CI: −3.59 to −3.06). Decreasing trends of MDR-TB were observed in most regions and countries, particularly that of death and DALYs in Slovenia were −18.96(95%CI: −20.82 to −17.06) and −19.35 (95%CI: −21.10 to −17.55), respectively. Whereas the pronounced increasing trends of MDR-TB occurred in Papua New Guinea, Singapore, and Australia.Conclusions the ASR of incidence, prevalence, death and DALYs of MDR-TB showed decreasing trends from 2000 to 2017. However, the MDR-TB burden remains a substantial challenge to the TB control globally, and requires effective control strategies and healthcare.

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“…To reduce the morbidity and mortality of MDR-TB, it is urgent that the government and researchers take measures to explore preventive strategies of MDR-TB risk among individuals with PTBH. Recently investigators have proved the significance of early prediction and assessment on the MDR-TB risk [7,8]. A white paper on the predictive, preventive and personalized medicine [9] suggested that a central component of preventive strategies is the identification of individuals at risk for development of a disease.…”

Section: Introductionmentioning

confidence: 99%

A simple-to-use nomogram for the individualized prediction of multidrug-resistant tuberculosis among individuals with previous tuberculosis history

Cheng

Zhao

Wang

et al. 2020

Preprint

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Background: So far, there are few studies that have investigated the risk of incident multidrug-resistant tuberculosis (MDR-TB) among individuals with previous tuberculosis history (PTBH), let alone developed a nomogram so as to comprehensively estimate an individualized risk of incident MDR-TB in this population. The present study was to construct a comprehensive nomogram for providing simple and precise personalized prediction of incident MDR-TB risk among individuals with PTBH.Methods: A matched case−control study (1: 2 ratios) was performed between 2005 and 2018 in Hangzhou City, China. A multivariable Cox proportional hazard regression was used to evaluate independent predictors of incident MDR-TB in individuals with PTBH. A comprehensive nomogram was developed based on the multivariable Cox model.Results: Overall, 1, 836 participants were included in this study. We developed a simple-to-use nomogram for predicting the individualized risk of incident MDR-TB by using the parameters of age < 60 years, a history of direct contact, passive mode of TB case finding, human immunodeficiency virus infection, re-treated TB history, unsuccessful treatment, 3HRZES/6HRE, duration of pulmonary cavities, and duration of positive sputum culture in individuals with PTBH. The concordance index of this nomogram was 0.833 [95% confidence interval (CI): 0.807-0.859] and 0.871 (95% CI 0.773-0.969) for the training and validation sets, respectively, which indicated adequate discriminatory power. The calibration curves for the risk of incident MDR-TB showed an optimal agreement between nomogram prediction and actual observation in the training and validation sets, respectively. The high sensitivity and specificity of nomogram was indicated by using a receiver operating characteristic curve analysis.Conclusions: We developed and validated a novel nomogram for predicting and preventing the risk of incident MDR-TB in individuals with PTBH. Through this clinic tool, TB control executives could more precisely monitor, estimate and intervene the risk of incident MDR-TB among individual PTB patients.

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Risk factors of multidrug-resistant tuberculosis: A global systematic review and meta-analysis

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Cited by 133 publications

References 38 publications

The Influence of Pharmacogenetic Variants in HIV/Tuberculosis Coinfected Patients in Uganda in the SOUTH Study

The Influence of Pharmacogenetic Variants in HIV/Tuberculosis Coinfected Patients in Uganda in the SOUTH Study

Trends in burden of multidrug-resistant tuberculosis in countries, regions, and worldwide from 1990 to 2017: results from the Global Burden of Disease Study

A simple-to-use nomogram for the individualized prediction of multidrug-resistant tuberculosis among individuals with previous tuberculosis history

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