Ismawati Ismail1, Awang Bulgiba. 1. Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya 50603 Kuala Lumpur, Malaysia. drismawati@gmail.com
Abstract
OBJECTIVES: To determine predictors of unsuccessful treatment in HIV-infected tuberculosis (TB) patients. METHODS: We reviewed medical records at the time of TB diagnosis and subsequent follow-up of all registered TB patients with HIV co-infection at TB clinics in the Institute of Respiratory Medicine and three public hospitals in Malaysia between January 2010 and September 2010. We reviewed these medical records again twelve months after their initial diagnosis to determine treatment outcomes. Multiple logistic regression was conducted to identify risk factors for unsuccessful TB treatment. RESULTS: Among the 219 patients analyzed, 53.4% achieved successful outcomes (cure, completed treatment) while 46.6% of patients had unsuccessful outcomes (default, treatment failure, died). After adjusting for other factors, unsuccessful outcome was associated with intravenous drug use (OR 2.72; 95% CI 1.44-5.16), not receiving antiretroviral therapy (OR 5.10; 95% CI 2.69-9.69), lymphadenopathy (OR 2.01; 95% CI 1.09-3.72) and low serum albumin (OR 4.61; 95% CI 1.73-12.27). CONCLUSION: Anti-retroviral treatment must be provided to all HIV-infected tuberculosis patients. Good immune and nutritional status needs to be assured in all HIV-infected tuberculosis patients. More studies are required in intravenous drug users to understand why tuberculosis treatment outcomes are poor in this group.
OBJECTIVES: To determine predictors of unsuccessful treatment in HIV-infected tuberculosis (TB) patients. METHODS: We reviewed medical records at the time of TB diagnosis and subsequent follow-up of all registered TB patients with HIV co-infection at TB clinics in the Institute of Respiratory Medicine and three public hospitals in Malaysia between January 2010 and September 2010. We reviewed these medical records again twelve months after their initial diagnosis to determine treatment outcomes. Multiple logistic regression was conducted to identify risk factors for unsuccessful TB treatment. RESULTS: Among the 219 patients analyzed, 53.4% achieved successful outcomes (cure, completed treatment) while 46.6% of patients had unsuccessful outcomes (default, treatment failure, died). After adjusting for other factors, unsuccessful outcome was associated with intravenous drug use (OR 2.72; 95% CI 1.44-5.16), not receiving antiretroviral therapy (OR 5.10; 95% CI 2.69-9.69), lymphadenopathy (OR 2.01; 95% CI 1.09-3.72) and low serum albumin (OR 4.61; 95% CI 1.73-12.27). CONCLUSION: Anti-retroviral treatment must be provided to all HIV-infected tuberculosispatients. Good immune and nutritional status needs to be assured in all HIV-infected tuberculosispatients. More studies are required in intravenous drug users to understand why tuberculosis treatment outcomes are poor in this group.
Authors: N B Bhatt; C Barau; A Amin; E Baudin; B Meggi; C Silva; V Furlan; B Grinsztejn; A Barrail-Tran; M Bonnet; A M Taburet Journal: Antimicrob Agents Chemother Date: 2014-03-24 Impact factor: 5.191
Authors: Jigar D Kapadia; Chetna K Desai; Manish N Solanki; Asha N Shah; R K Dikshit Journal: Indian J Pharmacol Date: 2013 Sep-Oct Impact factor: 1.200