%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Bastard, M.
%A Sanchez-Padilla, E.
%A du Cros, P.
%A Khamraev, A. K.
%A Parpieva, N.
%A Tillyashaykov, M.
%A Hayrapetyan, A.
%A Kimenye, K.
%A Khurkhumal, S.
%A Dlamini, T.
%A Perez, S. F.
%A Telnov, A.
%A Hewison, C.
%A Varaine, F.
%A Bonnet, Maryline
%T Outcomes of HIV-infected versus HIV-noninfected patients treated for drug-resistance tuberculosis : multicenter cohort study
%D 2018
%L fdi:010072491
%G ENG
%J PLoS One
%@ 1932-6203
%K ABKHAZIE, ARMENIE ; COLOMBIE ; KENYA ; KIRGHIZSTAN ; SWAZILAND ; OUZBEKISTAN.
%M ISI:000426902900022
%N 3
%P e0193491 [14 ]
%R 10.1371/journal.pone.0193491
%U https://www.documentation.ird.fr/hor/fdi:010072491
%> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/divers18-04/010072491.pdf
%V 13
%W Horizon (IRD)
%X 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.
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