Sputum culture reversion in longer treatments with bedaquiline, delamanid, and repurposed drugs for drug-resistant tuberculosis.

Autor: Kho S; Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA., Seung KJ; Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA.; Partners in Health, 800 Boylston Street Suite 300, Boston, MA, USA., Huerga H; Epicentre, 14-34 Avenue Jean Jaurès, Paris, France., Bastard M; Epicentre, 14-34 Avenue Jean Jaurès, Paris, France., Khan PY; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK.; Interactive Research and Development Global, Singapore, Singapore., Mitnick CD; Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA.; Partners in Health, 800 Boylston Street Suite 300, Boston, MA, USA.; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA., Rich ML; Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA.; Partners in Health, 800 Boylston Street Suite 300, Boston, MA, USA., Islam S; Interactive Research and Development, Dhaka, Bangladesh., Zhizhilashvili D; Médecins sans Frontières, Tbilisi, Georgia., Yeghiazaryan L; National Center for Pulmonology, Yerevan, Armenia., Nikolenko EN; Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus., Zarli K; Médecins sans Frontières, Yangon, Myanmar., Adnan S; Indus Hospital and Health Network, Karachi, Pakistan., Salahuddin N; Indus Hospital and Health Network, Karachi, Pakistan., Ahmed S; Interactive Research and Development, Karachi, Pakistan., Vargas ZHR; Maria Auxiliadora Hospital, San Juan de Miraflores, Peru., Bekele A; Department of Internal Medicine, Tikur Anbessa Specialized Hospital and Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia., Shaimerdenova A; Karaganda Regional Center of Phthisiopulmonology, Karaganda, Kazakhstan., Tamirat M; Partners in Health, Lesotho, Maseru, Lesotho., Gelin A; Zanmi Lasante, Port-au-Prince, Haiti., Vilbrun SC; Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti., Hewison C; Medical Department, Médecins sans Frontières, Paris, France., Khan U; Interactive Research and Development Global, Singapore, Singapore., Franke M; Partners in Health, 800 Boylston Street Suite 300, Boston, MA, USA. molly_franke@hms.harvard.edu.; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA. molly_franke@hms.harvard.edu.
Jazyk: angličtina
Zdroj: Nature communications [Nat Commun] 2024 May 09; Vol. 15 (1), pp. 3927. Date of Electronic Publication: 2024 May 09.
DOI: 10.1038/s41467-024-48077-8
Abstrakt: Sputum culture reversion after conversion is an indicator of tuberculosis (TB) treatment failure. We analyze data from the endTB multi-country prospective observational cohort (NCT03259269) to estimate the frequency (primary endpoint) among individuals receiving a longer (18-to-20 month) regimen for multidrug- or rifampicin-resistant (MDR/RR) TB who experienced culture conversion. We also conduct Cox proportional hazard regression analyses to identify factors associated with reversion, including comorbidities, previous treatment, cavitary disease at conversion, low body mass index (BMI) at conversion, time to conversion, and number of likely-effective drugs. Of 1,286 patients, 54 (4.2%) experienced reversion, a median of 173 days (97-306) after conversion. Cavitary disease, BMI < 18.5, hepatitis C, prior treatment with second-line drugs, and longer time to initial culture conversion were positively associated with reversion. Reversion was uncommon. Those with cavitary disease, low BMI, hepatitis C, prior treatment with second-line drugs, and in whom culture conversion is delayed may benefit from close monitoring following conversion.
(© 2024. The Author(s).)
Databáze: MEDLINE
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