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Abstract:

Objectives Mortality among HIV patients with tuberculosis (TB) remains high in Eastern Europe (EE), but details of TB and HIV management remain scarce. Methods In this prospective study, we describe the TB treatment regimens of patients with multi-drug resistant (MDR) TB and use of antiretroviral therapy (ART). Results A total of 105 HIV-positive patients had MDR-TB (including 33 with extensive drug resistance) and 130 pan-susceptible TB. Adequate initial TB treatment was provided for 8% of patients with MDR-TB compared with 80% of those with pan-susceptible TB. By twelve months, an estimated 57.3% (95%CI 41.5–74.1) of MDR-TB patients had started adequate treatment. While 67% received ART, HIV-RNA suppression was demonstrated in only 23%. Conclusions Our results show that internationally recommended MDR-TB treatment regimens were infrequently used and that ART use and viral suppression was well below the target of 90%, reflecting the challenging patient population and the environment in which health care is provided. Urgent improvement of management of patients with TB/HIV in EE, in particular for those with MDR-TB, is needed and includes widespread access to rapid TB diagnostics, better access to and use of second-line TB drugs, timely ART initiation with viral load monitoring, and integration of TB/HIV care. © 2017 The British Infection Association

Registro:

Documento: Artículo
Título:Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study
Autor:Efsen, A.M.W. et al.
Este artículo contiene 131 autores, consultelos en el artículo en formato pdf.
Filiación: Este artículo contiene 131 autores con sus filiaciones, consultelas en el artículo en formato pdf.
Palabras clave:Eastern Europe; HIV; MDR-TB; Tuberculosis; aminosalicylic acid; cycloserine; ethambutol; ethionamide; isoniazid; protionamide; pyrazinamide; quinoline derived antiinfective agent; rifampicin; streptomycin; terizidone; virus RNA; adult; antiretroviral therapy; Article; cohort analysis; drug efficacy; Eastern Europe; female; follow up; human; Human immunodeficiency virus infection; infection sensitivity; major clinical study; male; mixed infection; multidrug resistant tuberculosis; patient care; patient monitoring; prospective study; treatment outcome; virus load
Año:2018
Volumen:76
Número:1
Página de inicio:44
Página de fin:54
DOI: http://dx.doi.org/10.1016/j.jinf.2017.10.007
Título revista:Journal of Infection
Título revista abreviado:J. Infect.
ISSN:01634453
CODEN:JINFD
CAS:aminosalicylic acid, 133-10-8, 133-15-3, 28088-64-4, 51540-64-8, 65-49-6, 80702-32-5, 133-09-5; cycloserine, 339-72-0, 68-39-3, 68-41-7; ethambutol, 10054-05-4, 1070-11-7, 3577-94-4, 74-55-5; ethionamide, 536-33-4; isoniazid, 54-85-3, 62229-51-0, 65979-32-0; protionamide, 14222-60-7; pyrazinamide, 98-96-4; rifampicin, 13292-46-1; streptomycin, 57-92-1; terizidone, 25683-71-0
Registro:https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_01634453_v76_n1_p44_Efsen

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Citas:

---------- APA ----------
(2018) . Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study. Journal of Infection, 76(1), 44-54.
http://dx.doi.org/10.1016/j.jinf.2017.10.007
---------- CHICAGO ----------
Efsen, A.M.W. "Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study" . Journal of Infection 76, no. 1 (2018) : 44-54.
http://dx.doi.org/10.1016/j.jinf.2017.10.007
---------- MLA ----------
Efsen, A.M.W. "Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study" . Journal of Infection, vol. 76, no. 1, 2018, pp. 44-54.
http://dx.doi.org/10.1016/j.jinf.2017.10.007
---------- VANCOUVER ----------
Efsen, A.M.W. Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study. J. Infect. 2018;76(1):44-54.
http://dx.doi.org/10.1016/j.jinf.2017.10.007