Different profiles of body mass index variation among patients with multidrug-resistant tuberculosis: a retrospective cohort study

Autor: Alhassane Diallo, Boubacar Bah, Fulgence N’Zabintawali, Boubacar Diallo, Lansana Mady Camara, Oumou Sow, Mamadou Hassimiou Diallo, Lucrèce Ahouéfa Nadège Kounoudji, Miguel Carlos-Bolumbu
Přispěvatelé: Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Department of Epidemiology, Biostatistics, and Clinical Research [Paris], Centre d'Investigation Clinique – Épidémiologie Clinique [Paris], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Gamal Abdel Nasser de Conakry, Centre Antituberculeux de la Carrière [Conakry, Guinée], Laboratoire National des Mycobactéries [Conakry, Guinée], Urgences Réanimation [Paris], Centre Hospitalier Sud Essonnes (CHSE), Centre population et développement (CEPED - UMR_D 196), Institut de Recherche pour le Développement (IRD)-Université Paris Cité (UPCité), Bodescot, Myriam, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, Institut de Recherche pour le Développement (IRD)-Université de Paris (UP)
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Tuberculosis
030231 tropical medicine
HIV Infections
lcsh:Infectious and parasitic diseases
Body Mass Index
Medication Adherence
Cohort Studies
Young Adult
03 medical and health sciences
BMI
0302 clinical medicine
Interquartile range
Latent mixed models
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Internal medicine
Tuberculosis
Multidrug-Resistant

Culture conversion
Humans
Medicine
lcsh:RC109-216
Multidrug-resistant
030212 general & internal medicine
Antibiotics
Antitubercular

Depression (differential diagnoses)
Retrospective Studies
2. Zero hunger
Depression
business.industry
Weight change
Retrospective cohort study
Middle Aged
medicine.disease
3. Good health
Regimen
Dyspnea
Infectious Diseases
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie
[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Female
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Rifampin
business
Body mass index
Research Article
Zdroj: BMC Infectious Diseases
BMC Infectious Diseases, 2020, 20 (1), pp.315. ⟨10.1186/s12879-020-05028-0⟩
BMC Infectious Diseases, BioMed Central, 2020, 20 (1), pp.315. ⟨10.1186/s12879-020-05028-0⟩
BMC Infectious Diseases, Vol 20, Iss 1, Pp 1-10 (2020)
ISSN: 1471-2334
DOI: 10.1186/s12879-020-05028-0⟩
Popis: Background Despite the predictive role of body weight variation in treatment outcome in multidrug-resistant tuberculosis (MDR-TB), few corroborating data are available. We studied weight variation in patients with MDR-TB to identify groups of weight change and to determine factors that influence these changes. Methods We analyzed patients with rifampicin resistance who were treated with an MDR-TB treatment regimen between June 07, 2016 and June 22, 2018 at three major drug-resistant TB centers in Guinea. Patients were seen monthly until the end of treatment. Clinical outcome was the body mass index (BMI). We used a linear mixed model to analyze trajectories of BMI and a latent class mixed model to identify groups of BMI trajectories. Results Of 232 patients treated for MDR-TB during the study period, 165 were analyzed. These patients had a total of 1387 visits, with a median of 5 visits (interquartile range, 3–8 visits). Monthly BMI increase was 0.24 (SE 0.02) per kg/m2. Factors associated with faster BMI progression were success of MDR-TB treatment (0.24 [SE 0.09] per kg/m2; p = 0.0205) and absence of lung cavities on X-ray (0.18 [0.06] per kg/m2; p = 0.0068). Two groups of BMI change were identified: rapid BMI increase (n = 121; 85%) and slow BMI increase (n = 22; 15%). Patients in the slow BMI increase group were mostly female (68%) had no history of TB treatment (41%), had a positive HIV infection (59%), and had a more severe clinical condition at baseline, characterized by a higher frequency of symptoms including depression (18%), dyspnea (68%), poor adherence to MDR-TB treatment (64%), lower platelet count, and higher SGOT. These patients also had a longer time to initial culture conversion (log-rank test: p = 0.0218). Conclusion Quantitative BMI data on patients with MDR-TB treated with a short regimen allowed the identification of subgroups of patients with different trajectories of BMI and emphasized the usefulness of BMI as a biomarker for the monitoring of MDR-TB treatment outcome.
Databáze: OpenAIRE