Relapse rates after short-course (6-month) treatment of tuberculosis in HIV-infected and uninfected persons
| Autor: | Richard E. Chaisson, Karla Alwood, William R. Bishai, William Coggin, David L. Blazes, Regina Gachuhi, Timothy R. Sterling |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Tuberculosis Adolescent Immunology Antitubercular Agents Sputum culture Cohort Studies Acquired immunodeficiency syndrome (AIDS) Recurrence Internal medicine Isoniazid medicine Humans Immunology and Allergy Child Ethambutol Aged Antibacterial agent Aged 80 and over AIDS-Related Opportunistic Infections medicine.diagnostic_test business.industry Infant Middle Aged Pyrazinamide medicine.disease Surgery Infectious Diseases Child Preschool Female Rifampin business Follow-Up Studies medicine.drug Cohort study |
| Zdroj: | AIDS. 13:1899-1904 |
| ISSN: | 0269-9370 |
| Popis: | Objective: To determine the rate of tuberculosis relapse among HIV-seropositive and -seronegative persons treated for active tuberculosis with short-course (6-month) therapy. Design: Consecutive cohort study. Setting: City of Baltimore tuberculosis clinic. Patients: Tuberculosis patients treated between 1 January 1993 and 31 December 1996. Intervention: Patients received 2 months of isoniazid, rifampin, pyrazinamide and ethambutol followed by 4 months of isoniazid and rifampin. Main outcome measure: Passive follow-up for tuberculosis relapse was performed through September 30, 1998. Results: There were 423 cases of tuberculosis during the study period; 280 patients completed a 6-month course of therapy. Therapy was directly-observed for 94% of patients. Of those who completed therapy, 47 (17%) were HIV-seropositive, 127 (45%) were HIV-seronegative, and 106 (38%) had unknown HIV status. HIV-infected patients required more time to complete therapy (median 225 versus 205 days; P=0.04) but converted sputum culture to negative within the same time period (median 77 versus 72 days; P=0.43) as HIV-seronegative or unknown patients. Relapse occurred in three out of 47 (6.4%) HIV-infected patients compared to seven out of 127 (5.5%) HIV-seronegative patients (P=1.0). Relapse rates also did not differ when HIV-seropositive patients were compared with HIV-seronegative and patients with unknown HIV status (6.4% versus 3.0%; P=0.38). Of the 10 patients with tuberculosis relapse, restriction fragment length polymorphism data were available for five; all five relapse isolates matched the initial isolate. Conclusions: These results support current recommendations to treat tuberculosis in HIV-infected patients with short-course (6-month) therapy. |
| Databáze: | OpenAIRE |
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