Rifampicin resistance and mortality in patients hospitalised with HIV-associated tuberculosis

被引：1

作者：

Spies, Ruan ^{[1
]}

Schutz, Charlotte ^{[2
,3
,4
]}

Ward, Amy ^{[2
,3
,4
]}

Balfour, Avuyonke ^{[3
,4
]}

Shey, Muki ^{[2
,3
,4
]}

Nicol, Mark ^{[4
,5
]}

Burton, Rosie ^{[6
]}

Sossen, Bianca ^{[2
,3
,4
]}

Wilkinson, Robert ^{[3
,4
,7
,8
]}

Barr, David ^{[3
,4
,9
]}

Meintjes, Graeme ^{[2
,3
,4
]}

机构：

[1] New Somerset Hosp, Dept Med, Cape Town, South Africa

[2] Univ Cape Town, Fac Hlth Sci, Dept Med, Cape Town, South Africa

[3] Univ Cape Town, Wellcome Ctr Infect Dis Res Africa CIDRI Africa, Cape Town, South Africa

[4] Univ Cape Town, Inst Infect Dis & Mol Med, Fac Hlth Sci, Cape Town, South Africa

[5] Univ Western Australia, Sch Biomed Sci, Div Infect & Immun, Perth, Australia

[6] Medecins Sans Frontieres, Cape Town, South Africa

[7] Francis Crick Inst, London, England

[8] UCL, Dept Infect Dis, London, England

[9] Univ Liverpool, Inst Infect & Global Hlth, Liverpool, England

来源：

SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE | 2022年 / 23卷 / 01期

基金：

英国医学研究理事会; 英国惠康基金; 新加坡国家研究基金会; 美国国家卫生研究院;

关键词：

HIV-associated tuberculosis; rifampicin-resistant tuberculosis; drug-resistant tuberculosis; multi-drug resistant TB; TB; Khayelitsha Hospital; TREATMENT OUTCOMES; TB PATIENTS; BEDAQUILINE; KHAYELITSHA; PREDICTORS;

D O I：

10.4102/sajhivmed.v23i1.1396

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background: Patients with HIV and drug-resistant tuberculosis (TB) are at high risk of death. Objectives: We investigated the association between rifampicin-resistant TB (RR-TB) and mortality in a cohort of patients who were admitted to hospital at the time of TB diagnosis. Method: Adults hospitalised at Khayelitsha Hospital and diagnosed with HIV-associated TB during admission, were enrolled between 2013 and 2016. Clinical,biochemical and microbiological data were prospectively collected and participants were followed up for 12 weeks.Results: Participants with microbiologically confirmed TB (n = 482) were enrolled a median of two days (interquartile range [IQR]: 1-3 days) following admission. Fifty-three participants (11.0%) had RR-TB. Participants with rifampicin-susceptible TB (RS-TB) received appropriate treatment a median of one day (IQR: 1-2 days) following enrolment compared to three days (IQR: 1-9 days) in participants with RR-TB. Eight participants with RS-TB (1.9%) and six participants with RR-TB (11.3%) died prior to the initiation of appropriate treatment. Mortality at 12 weeks was 87/429 (20.3%) in the RS-TB group and 21/53 (39.6%) in the RR-TB group. RR-TB was a significant predictor of 12-week mortality (hazard ratio: 1.88; 95% confidence interval: 1.07-3.29; P = 0.03).Conclusion: Mortality at 12 weeks in participants with RR-TB was high compared to participants with RS-TB. Delays in the initiation of appropriate treatment and poorer regimen efficacy are proposed as contributors to higher mortality in hospitalised patients with HIV and RR-TB.

引用

页数：8