Treatment outcomes and predictive factors for multidrug-resistant TB and HIV coinfection in Rio de Janeiro State, Brazil

Bhering, Marcela; Duarte, Raquel; Kritski, Afrânio Lineu

doi:10.5588/ijtld.20.0887

Cited by 11 publications

(3 citation statements)

References 18 publications

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“…14,16,23 When it came to poor treatment outcomes, retreatment tuberculosis was not a risk factor anymore. Studies had shown that retreated patients with a history of drug-resistant tuberculosis treatment had a higher risk of poor treatment outcomes, 14,16,25 But this study did not further analyze the previous treatment, which may be the reason for the low odds ratio of this study and the failure to conclude when analyzing the influencing factors of poor treatment outcomes. Therefore, treatment history and drugs ever used should be acquired before starting treatment.…”

Section: Discussionmentioning

confidence: 83%

Treatment Outcomes and Risk Factors of Multidrug-Resistant Tuberculosis Patients in Xi’an China, a Retrospective Cohort Study

Ma¹,

Zeng²,

Ren³

et al. 2022

IDR

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Long-term regimens are widely used for multidrug-resistant tuberculosis (MDR-TB) in North-West China; however, risk factors associated with the treatment outcomes are not well known. Methods: This was a retrospective cohort study of MDR-TB patients treated with longer regimen in Xi'an from 2017 to 2019. Risk factors associated with the treatment outcome were analyzed using multiple logistic regression. Results: Of the 446 patients with MDR-TB included, 215 were cured, 84 completed treatment, 23 failed treatment, 108 were lost to follow-up, and 16 died. Unfavorable outcome risk factors were age >40 years (OR = 3.25, 95% CI = 2.12-4.98), male sex (OR = 2.53, 95% CI = 1.52-4.22), and re-treated tuberculosis (OR = 1.70, 95% CI = 1.11-2.61), whereas poor treatment outcome risk factors were age >40 years (OR = 5.51, 95% CI = 2.52-12.07), fluoroquinolones not used in the regimen (OR = 3.31, 95% CI = 1.45-7.51), and smear-positive (OR = 4.0, 95% CI = 1.47-10.8). Conclusion:In Xi'an, MDR-TB treatments with long-term regimens had low success rates, and age, sex, and tuberculosis treatment history were risk factors of MDR-TB treatment outcomes.

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Section: Discussionmentioning

confidence: 83%

Treatment Outcomes and Risk Factors of Multidrug-Resistant Tuberculosis Patients in Xi’an China, a Retrospective Cohort Study

Ma¹,

Zeng²,

Ren³

et al. 2022

IDR

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“…Studies have already found this result [ 9 , 31 , 32 ], as well as the greater occurrence of adverse effects and drug interactions in these cases [ 33 ]. The early diagnosis of drug resistance, the appropriate definition of the treatment, and the rapid initiation of antiretroviral therapy (ART) two weeks after starting TB treatment, if the patient is not already on ART, are recommendations for the treatment of co-infected patients [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Brazilian cohort study of risk factors associated with unsuccessful outcomes of drug resistant tuberculosis

et al. 2021

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Background Treatment outcomes were evaluated of a cohort of new pulmonary tuberculosis (TB) cases that were rifampicin resistant, multidrug-resistant, or extensively resistant during 2013 and 2014 in Brazil. The objective of this study is to identify factors associated with unfavorable treatment outcomes for drug-resistant TB cases. Methods The Brazilian Special Tuberculosis Treatment Information System (SITE-TB) was the main data source. The independent variables were classified into four blocks (block I: individual characteristics; block II: clinical characteristics and proposed treatment; block III: treatment follow-up characteristics; and block IV: TB history). The category of successful therapeutic outcome was compared with lost to follow-up, failure, and death. Considering the multiple outcomes as the dependent variable, the odds ratios (OR) and its respective 95% confidence interval (95% CI) were estimated by multinomial logistic regression. Results After applying the exclusion criteria, 980 (98.8%) individuals were included in the study. Of these, 621 (63.4%) had successful treatment, 163 (16.6%) lost to follow-up, 76 (7.8%) failed, and 120 (12.2%) died. Important factors associated with lost to follow-up in the final model included use of illicit drugs (OR = 2.5 95% CI: 1.57–3.82). Outcome failure was associated with having disease in both lungs (OR = 2.0; 95% CI: 1.09–3.62) and using more than one or not using injectable medication (OR = 2.8; 95% CI: 1.05–7.69). Major factors for the death outcome were at least 60 years old (OR = 3.4; 95% CI: 1.90–6.03) and HIV positive (OR = 2.7; 95% CI: 1.45–4.83). Conclusions The factors associated with unfavorable treatment outcomes were different. Some of these factors are specific to each outcome, which reflects the complexity of providing care to these individuals.

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“…Moreover, there was no significant between-group difference regarding CD4 cell count. The risk of treatment failure is higher in patients with MDR-TB than in those with non-MDR-TB, and this effect is more prominent in HIV-infected patients [ 10 11 ]. Prompt initiation of appropriate anti-TB drugs is essential for treating HIV/TB co-infection.…”

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confidence: 99%

Prevalence of Multidrug-Resistant Tuberculosis in HIV/Tuberculosis Co-Infected Patients

Lee

Bang

et al. 2021

Infect Chemother

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Tuberculosis (TB) is a common opportunistic infection in human immunodeficiency virus (HIV)-infected patients. Patients with multidrug-resistant (MDR)-TB have poor outcomes. This study aimed to determine the prevalence of MDR-TB in HIV/TB co-infected patients in the Korea. We reviewed the medical records of HIV/TB co-infected patients at two university hospitals between January 1998 and December 2020. During the study period, a total of 87 HIV/TB co-infected patients were identified, and drug susceptibility test results were available for 44 of them. The prevalence of MDR-TB in the study population was 15.9% (7/44, 95% confidence interval, 5.1 - 26.7).

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Treatment outcomes and predictive factors for multidrug-resistant TB and HIV coinfection in Rio de Janeiro State, Brazil

Cited by 11 publications

References 18 publications

Treatment Outcomes and Risk Factors of Multidrug-Resistant Tuberculosis Patients in Xi’an China, a Retrospective Cohort Study

Treatment Outcomes and Risk Factors of Multidrug-Resistant Tuberculosis Patients in Xi’an China, a Retrospective Cohort Study

Brazilian cohort study of risk factors associated with unsuccessful outcomes of drug resistant tuberculosis

Prevalence of Multidrug-Resistant Tuberculosis in HIV/Tuberculosis Co-Infected Patients

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