Bastard M., Sanchez-Padilla E., du Cros P., Khamraev A. K., Parpieva N., Tillyashaykov M., Hayrapetyan A., Kimenye K., Khurkhumal S., Dlamini T., Perez S. F., Telnov A., Hewison C., Varaine F., Bonnet Maryline. (2018). Outcomes of HIV-infected versus HIV-noninfected patients treated for drug-resistance tuberculosis : multicenter cohort study. PLoS One, 13 (3), p. e0193491 [14 p.]. ISSN 1932-6203.
Titre du document
Outcomes of HIV-infected versus HIV-noninfected patients treated for drug-resistance tuberculosis : multicenter cohort study
Année de publication
2018
Auteurs
Bastard M., Sanchez-Padilla E., du Cros P., Khamraev A. K., Parpieva N., Tillyashaykov M., Hayrapetyan A., Kimenye K., Khurkhumal S., Dlamini T., Perez S. F., Telnov A., Hewison C., Varaine F., Bonnet Maryline
Source
PLoS One, 2018,
13 (3), p. e0193491 [14 p.] ISSN 1932-6203
Background The emergence of resistance to anti-tuberculosis (DR-TB) drugs and the HIV epidemic represent a serious threat for reducing the global burden of TB. Although data on HIV-negative DR-TB treatment outcomes are well published, few data on DR-TB outcomes among HIV co-infected people is available despite the great public health importance. Methods We retrospectively reported and compared the DR-TB treatment outcomes of HIV-positive and HIV-negative patients treated with an individualized regimen based on WHO guidelines in seven countries: Abkhazia, Armenia, Colombia, Kenya, Kyrgyzstan, Swaziland and Uzbekistan. Results Of the 1,369 patients started DRTB treatment, 809 (59.1%) were multi-drug resistant (MDR-TB) and 418 (30.5%) were HIV-positive. HIV-positive patients were mainly from African countries (90.1%) while HIV-negative originated from Former Soviet Union (FSU) countries. Despite a higher case fatality rate (19.0% vs 9.4%), HIV-positive MDR-TB patients had a 10% higher success rate than HIV-negative patients (64.0% vs 53.2%, p = 0.007). No difference in treatment success was found among polydrug-resistant (PDR-TB) patients. Overall, lost to follow-up rate was much higher among HIV-negative (22.0% vs. 8.4%). Older age and not receiving ART were the only factors associated with unfavorable treatment outcome among HIV-positive patients. Conclusions As already known for HIV-negative patients, success rate of DR-TB HIV-positive patients remains low and requires more effective DR-TB regimen using new drugs also suitable to HIV-infected patients on ART. The study also confirms the need of ART introduction in HIV co-infected patients.
Plan de classement
Santé : généralités [050]
;
Entomologie médicale / Parasitologie / Virologie [052]
Description Géographique
ABKHAZIE, ARMENIE ; COLOMBIE ; KENYA ; KIRGHIZSTAN ; SWAZILAND ; OUZBEKISTAN.
Localisation
Fonds IRD [F B010072491]
Identifiant IRD
fdi:010072491
