Impact of drug-resistant tuberculosis on the survival of HIV-infected patients

被引:0
作者
Sungkanuparph, S. [1 ]
Eampokalap, B.
Chottanapund, S.
Thongyen, S.
Manosuthi, W.
机构
[1] Mahidol Univ, Ramathibodi Hosp, Fac Med, Dept Med,Div Infect Dis, Bangkok 10400, Thailand
[2] Minist Publ Hlth, Bamrasnaradura Infect Dis Inst, Nonthaburi, Thailand
关键词
tuberculosis; drug resistance; survival; HIV; AIDS;
D O I
暂无
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
OBJECTIVE: To determine the effect of drug-resistant tuberculosis (TB) on the survival of human immunodeficiency virus (HIV) infected patients in an area with a high prevalence of TB. DESIGN: Retrospective cohort study. RESULTS: Of 225 HIV-TB patients with a mean age of 35.8 years, 72.4% were male. The median CD4 cell count at TB diagnosis was 44 cells/mm(3). Sixty per cent presented with extra-pulmonary TB (EPTB). Sixty-three (28%) patients were infected with Mycobacterium tuberculosis resistant to at least one drug; respectively 16.4%, 9.3%, 5.3% and 12.9% were resistant to isoniazid (INH), rifampicin (RMP), ethambutol and streptomycin, and 14 (6.2%) had multidrug-resistant TB (MDR-TB). During a median follow-up of 11.5 months, 4% died. From Kaplan-Meier analysis, INH resistance, RMP resistance and MDR-TB were associated with shorter survival (log-rank test, P < 0.005). Cox's proportional hazard model showed that MDR-TB (hazard ratio [HR] 11.7; 95% CI 2.1-64.9), not receiving antiretroviral therapy (ART) (FIR 7.9; 95%CI 1.5-43.1) and EPTB (HR 5.1; 95%CI 1.925.9) were significant risk factors for death. CONCLUSION: MDR-TB and EPTB substantially reduce survival among patients co-infected with HIV and TB. Early detection and optimal treatment of MDR-TB are crucial. ART significantly prolongs survival and should be initiated in HIV-TB co-infected patients.
引用
收藏
页码:325 / 330
页数:6
相关论文
共 29 条
  • [11] DETECTION AND IDENTIFICATION OF MYCOBACTERIUM-TUBERCULOSIS DIRECTLY FROM SPUTUM SEDIMENTS BY AMPLIFICATION OF RIBOSOMAL-RNA
    JONAS, V
    ALDEN, MJ
    CURRY, JI
    KAMISANGO, K
    KNOTT, CA
    LANKFORD, R
    WOLFE, JM
    MOORE, DF
    [J]. JOURNAL OF CLINICAL MICROBIOLOGY, 1993, 31 (09) : 2410 - 2416
  • [12] Single-tube, nested, reverse transcriptase PCR for detection of viable Mycobacterium tuberculosis
    Jou, NT
    Yoshimori, RB
    Mason, GR
    Louie, JS
    Liebling, MR
    [J]. JOURNAL OF CLINICAL MICROBIOLOGY, 1997, 35 (05) : 1161 - 1165
  • [13] HIV-associated tuberculosis and cryptococcosis in resource-limited settings.
    Lalloo U.G.
    Amod F.C.
    [J]. Current HIV/AIDS Reports, 2005, 2 (3) : 116 - 121
  • [14] Immune reconstitution inflammatory syndrome of tuberculosis among HIV-infected patients receiving antituberculous and antiretroviral therapy
    Manosuthi, Weerawat
    Kiertiburanakul, Sasisopin
    Phoorisri, Thanongsri
    Sungkanuparph, Somnuek
    [J]. JOURNAL OF INFECTION, 2006, 53 (06) : 357 - 363
  • [15] Antituberculosis drug resistance and anonymous HIV surveillance in tuberculosis patients in Botswana, 2002
    Nelson, LJ
    Talbot, EA
    Mwasekaga, MJ
    Ngirubiu, PK
    Mwansa, RA
    Notha, M
    Wells, CD
    [J]. LANCET, 2005, 366 (9484) : 488 - 490
  • [16] Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection
    Palella, FJ
    Delaney, KM
    Moorman, AC
    Loveless, MO
    Fuhrer, J
    Satten, GA
    Aschman, DJ
    Holmberg, SD
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1998, 338 (13) : 853 - 860
  • [17] Punnotok J, 2000, INT J TUBERC LUNG D, V4, P537
  • [18] Putong Nimfa M., 2002, Southeast Asian Journal of Tropical Medicine and Public Health, V33, P346
  • [19] Quy HT, 2006, INT J TUBERC LUNG D, V10, P45
  • [20] GLOBAL EPIDEMIOLOGY OF TUBERCULOSIS - MORBIDITY AND MORTALITY OF A WORLDWIDE EPIDEMIC
    RAVIGLIONE, MC
    SNIDER, DE
    KOCHI, A
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1995, 273 (03): : 220 - 226