BACKGROUND: Tuberculosis is a leading cause of morbidity and mortality worldwide. Patients with extensively drug-resistant tuberculosis (XDR-TB) have had high mortality rates, especially when coinfected with HIV. METHODS: A retrospective cohort study of the first 206 patients treated for XDR-TB in Eastern Cape Province, South Africa, October 2006 to January 2008, a province that has treated multidrug-resistant tuberculosis since 2000. All 206 patients were hospitalized for treatment until monthly sputum specimens were culture negative. RESULTS: Sixty-five patients diagnosed with XDR-TB died before XDR-TB treatment start. Among 195 patients starting treatment with a known HIV status, 108 (55.4%) were HIV positive, and 86 patients (44.1%) died during the first year of treatment. HIV-positive patients receiving antiretroviral treatment (ARVs) fared and HIV-negative patients, and more of both these groups survived than HIV-positive patients not on ARVs. However, HIV-negative patients experienced more serious adverse events requiring the withdrawal of medications than did HIV-positive patients, regardless of the use of ARVs. CONCLUSIONS: Experience in Eastern Cape Province, South Africa, suggests that patients can be treated for both XDR-TB and HIV. We have also shown that such combination therapy can be well tolerated by patients.
BACKGROUND:Tuberculosis is a leading cause of morbidity and mortality worldwide. Patients with extensively drug-resistant tuberculosis (XDR-TB) have had high mortality rates, especially when coinfected with HIV. METHODS: A retrospective cohort study of the first 206 patients treated for XDR-TB in Eastern Cape Province, South Africa, October 2006 to January 2008, a province that has treated multidrug-resistant tuberculosis since 2000. All 206 patients were hospitalized for treatment until monthly sputum specimens were culture negative. RESULTS: Sixty-five patients diagnosed with XDR-TB died before XDR-TB treatment start. Among 195 patients starting treatment with a known HIV status, 108 (55.4%) were HIV positive, and 86 patients (44.1%) died during the first year of treatment. HIV-positive patients receiving antiretroviral treatment (ARVs) fared and HIV-negative patients, and more of both these groups survived than HIV-positive patients not on ARVs. However, HIV-negative patients experienced more serious adverse events requiring the withdrawal of medications than did HIV-positive patients, regardless of the use of ARVs. CONCLUSIONS: Experience in Eastern Cape Province, South Africa, suggests that patients can be treated for both XDR-TB and HIV. We have also shown that such combination therapy can be well tolerated by patients.
Authors: Philippe Glaziou; Katherine Floyd; Eline L Korenromp; Charalambos Sismanidis; Ana L Bierrenbach; Brian G Williams; Rifat Atun; Mario Raviglione Journal: Bull World Health Organ Date: 2011-05-31 Impact factor: 9.408
Authors: Keertan Dheda; Tawanda Gumbo; Neel R Gandhi; Megan Murray; Grant Theron; Zarir Udwadia; G B Migliori; Robin Warren Journal: Lancet Respir Med Date: 2014-03-24 Impact factor: 30.700
Authors: Payam Nahid; Sundari R Mase; Giovanni Battista Migliori; Giovanni Sotgiu; Graham H Bothamley; Jan L Brozek; Adithya Cattamanchi; J Peter Cegielski; Lisa Chen; Charles L Daley; Tracy L Dalton; Raquel Duarte; Federica Fregonese; C Robert Horsburgh; Faiz Ahmad Khan; Fayez Kheir; Zhiyi Lan; Alfred Lardizabal; Michael Lauzardo; Joan M Mangan; Suzanne M Marks; Lindsay McKenna; Dick Menzies; Carole D Mitnick; Diana M Nilsen; Farah Parvez; Charles A Peloquin; Ann Raftery; H Simon Schaaf; Neha S Shah; Jeffrey R Starke; John W Wilson; Jonathan M Wortham; Terence Chorba; Barbara Seaworth Journal: Am J Respir Crit Care Med Date: 2019-11-15 Impact factor: 21.405
Authors: N R Gandhi; J R Andrews; J C M Brust; R Montreuil; D Weissman; M Heo; A P Moll; G H Friedland; N S Shah Journal: Int J Tuberc Lung Dis Date: 2012-01 Impact factor: 2.373
Authors: Gilbert Lazarus; Kevin Tjoa; Anthony William Brian Iskandar; Melva Louisa; Evans L Sagwa; Nesri Padayatchi; Vivian Soetikno Journal: PLoS One Date: 2021-03-04 Impact factor: 3.240
Authors: Max R O'Donnell; Nesri Padayatchi; Charlotte Kvasnovsky; Lise Werner; Iqbal Master; C Robert Horsburgh Journal: Emerg Infect Dis Date: 2013-03 Impact factor: 6.883
Authors: Marisa Klopper; Robin Mark Warren; Cindy Hayes; Nicolaas Claudius Gey van Pittius; Elizabeth Maria Streicher; Borna Müller; Frederick Adriaan Sirgel; Mamisa Chabula-Nxiweni; Ebrahim Hoosain; Gerrit Coetzee; Paul David van Helden; Thomas Calldo Victor; André Phillip Trollip Journal: Emerg Infect Dis Date: 2013-03 Impact factor: 6.883