Outcomes of HIV-infected patients treated for recurrent tuberculosis with the standard retreatment regimen

Int J Tuberc Lung Dis. 2012 Jun;16(6):841-5. doi: 10.5588/ijtld.11.0210. Epub 2012 Apr 9.

Abstract

Setting: The Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (the GHESKIO AIDS and TB Center) in Port-au-Prince, Haiti.

Objective: To measure the effectiveness of the standard TB retreatment regimen (2HRZES/1HRZE/5HRE) in human immunodeficiency virus (HIV) infected adults.

Design: Cohort study.

Results: Of 1318 HIV-infected patients with access to antiretroviral therapy following World Health Organization guidelines, 56 were diagnosed with recurrent pulmonary TB and retreated with the standard retreatment regimen: 10 patients (18%) died during retreatment, 3 (5%) defaulted, and 2 (4%) failed treatment. Forty-one patients (73%) achieved retreatment 'success' (cure, treatment completed). Of these, 8 (20%) died during follow-up, 5 (12%) were lost, and 5 (12%) had a second recurrence of TB. Only 26 (46%) of the 56 patients remained alive, in care, and TB-free after a median of 36 months of follow-up.

Conclusion: HIV-infected patients treated for recurrent TB with the standard retreatment regimen have high mortality and poor long-term outcomes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis
  • AIDS-Related Opportunistic Infections / drug therapy*
  • AIDS-Related Opportunistic Infections / mortality
  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Antitubercular Agents / therapeutic use*
  • Chi-Square Distribution
  • Cohort Studies
  • Coinfection*
  • Drug Therapy, Combination
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / drug therapy*
  • HIV Infections / mortality
  • Haiti / epidemiology
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Practice Guidelines as Topic
  • Proportional Hazards Models
  • Recurrence
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Tuberculosis, Pulmonary / diagnosis
  • Tuberculosis, Pulmonary / drug therapy*
  • Tuberculosis, Pulmonary / mortality

Substances

  • Anti-HIV Agents
  • Antitubercular Agents