HIV-positive patients treated for multidrug-resistant tuberculosis: clinical outcomes in the HAART era
Palacios, E.; Franke, M.; Muñoz, M.; Hurtado, R.; Dallman, R.; Chalco, K.; Guerra, D.; Mestanza, L.; Llaro, K.; Bonilla, C.; Sebastian, J.; Bayona, J.; Lygizos, M.; Lyzigos, M.; Anger, H.; Shin, S.
International Journal of Tuberculosis and Lung Disease the Official Journal of the International Union Against Tuberculosis and Lung Disease 16(3): 348-354
2012
ISSN/ISBN: 1815-7920 PMID: 22640448 DOI: 10.5588/ijtld.11.0473Document Number: 561717
Multidrug-resistant tuberculosis (MDR-TB) and the human immunodeficiency virus (HIV) pose two of the greatest threats to global tuberculosis (TB) control. Given expanding global access to antiretroviral therapy (ART) and second-line TB drugs, more data are needed on experiences treating MDR-TB and HIV co-infection in resource-poor settings. To describe the clinical characteristics, management, outcomes, and factors associated with survival among HIV-positive individuals receiving treatment for MDR-TB. This was a retrospective case series of 52 HIV-positive individuals receiving treatment for MDR-TB in Lima, Peru. We used Cox proportional hazards regression models to identify risk factors for mortality. A total of 31 (57%) of the cohort died on treatment, with the majority of deaths due to MDR-TB. Low baseline weight predicted a three-fold increased rate of death (aHR 3.1, 95%CI 1.5-6.7), while individuals receiving highly active ART experienced a significantly lower rate of death compared to those who were not (aHR 0.4, 95%CI 0.2-0.9). Early ART is likely a key component of effective MDR-TB management in co-infected individuals.