Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study

Objectives Mortality among HIV patients with tuberculosis (TB) remains high in Eastern Europe (EE), but details of TB and HIV management remain scarce. Methods In this prospective study, we describe the TB treatment regimens of patients with multi-drug resistant (MDR) TB and use of antiretroviral th...

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Publicado:	2018
Materias:	Eastern Europe HIV MDR-TB Tuberculosis aminosalicylic acid cycloserine ethambutol ethionamide isoniazid protionamide pyrazinamide quinoline derived antiinfective agent rifampicin streptomycin terizidone virus RNA adult antiretroviral therapy Article cohort analysis drug efficacy female follow up human Human immunodeficiency virus infection infection sensitivity major clinical study male mixed infection multidrug resistant tuberculosis patient care patient monitoring prospective study treatment outcome virus load
Acceso en línea:	https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_01634453_v76_n1_p44_Efsen http://hdl.handle.net/20.500.12110/paper_01634453_v76_n1_p44_Efsen
Aporte de:	Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA) de Universidad de Buenos Aires

id	paper:paper_01634453_v76_n1_p44_Efsen
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spelling	paper:paper_01634453_v76_n1_p44_Efsen2023-06-08T15:14:21Z Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study Eastern Europe HIV MDR-TB Tuberculosis aminosalicylic acid cycloserine ethambutol ethionamide isoniazid protionamide pyrazinamide quinoline derived antiinfective agent rifampicin streptomycin terizidone virus RNA adult antiretroviral therapy Article cohort analysis drug efficacy Eastern Europe female follow up human Human immunodeficiency virus infection infection sensitivity major clinical study male mixed infection multidrug resistant tuberculosis patient care patient monitoring prospective study treatment outcome virus load Objectives Mortality among HIV patients with tuberculosis (TB) remains high in Eastern Europe (EE), but details of TB and HIV management remain scarce. Methods In this prospective study, we describe the TB treatment regimens of patients with multi-drug resistant (MDR) TB and use of antiretroviral therapy (ART). Results A total of 105 HIV-positive patients had MDR-TB (including 33 with extensive drug resistance) and 130 pan-susceptible TB. Adequate initial TB treatment was provided for 8% of patients with MDR-TB compared with 80% of those with pan-susceptible TB. By twelve months, an estimated 57.3% (95%CI 41.5–74.1) of MDR-TB patients had started adequate treatment. While 67% received ART, HIV-RNA suppression was demonstrated in only 23%. Conclusions Our results show that internationally recommended MDR-TB treatment regimens were infrequently used and that ART use and viral suppression was well below the target of 90%, reflecting the challenging patient population and the environment in which health care is provided. Urgent improvement of management of patients with TB/HIV in EE, in particular for those with MDR-TB, is needed and includes widespread access to rapid TB diagnostics, better access to and use of second-line TB drugs, timely ART initiation with viral load monitoring, and integration of TB/HIV care. © 2017 The British Infection Association 2018 https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_01634453_v76_n1_p44_Efsen http://hdl.handle.net/20.500.12110/paper_01634453_v76_n1_p44_Efsen
institution	Universidad de Buenos Aires
institution_str	I-28
repository_str	R-134
collection	Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA)
topic	Eastern Europe HIV MDR-TB Tuberculosis aminosalicylic acid cycloserine ethambutol ethionamide isoniazid protionamide pyrazinamide quinoline derived antiinfective agent rifampicin streptomycin terizidone virus RNA adult antiretroviral therapy Article cohort analysis drug efficacy Eastern Europe female follow up human Human immunodeficiency virus infection infection sensitivity major clinical study male mixed infection multidrug resistant tuberculosis patient care patient monitoring prospective study treatment outcome virus load
spellingShingle	Eastern Europe HIV MDR-TB Tuberculosis aminosalicylic acid cycloserine ethambutol ethionamide isoniazid protionamide pyrazinamide quinoline derived antiinfective agent rifampicin streptomycin terizidone virus RNA adult antiretroviral therapy Article cohort analysis drug efficacy Eastern Europe female follow up human Human immunodeficiency virus infection infection sensitivity major clinical study male mixed infection multidrug resistant tuberculosis patient care patient monitoring prospective study treatment outcome virus load Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study
topic_facet	Eastern Europe HIV MDR-TB Tuberculosis aminosalicylic acid cycloserine ethambutol ethionamide isoniazid protionamide pyrazinamide quinoline derived antiinfective agent rifampicin streptomycin terizidone virus RNA adult antiretroviral therapy Article cohort analysis drug efficacy Eastern Europe female follow up human Human immunodeficiency virus infection infection sensitivity major clinical study male mixed infection multidrug resistant tuberculosis patient care patient monitoring prospective study treatment outcome virus load
description	Objectives Mortality among HIV patients with tuberculosis (TB) remains high in Eastern Europe (EE), but details of TB and HIV management remain scarce. Methods In this prospective study, we describe the TB treatment regimens of patients with multi-drug resistant (MDR) TB and use of antiretroviral therapy (ART). Results A total of 105 HIV-positive patients had MDR-TB (including 33 with extensive drug resistance) and 130 pan-susceptible TB. Adequate initial TB treatment was provided for 8% of patients with MDR-TB compared with 80% of those with pan-susceptible TB. By twelve months, an estimated 57.3% (95%CI 41.5–74.1) of MDR-TB patients had started adequate treatment. While 67% received ART, HIV-RNA suppression was demonstrated in only 23%. Conclusions Our results show that internationally recommended MDR-TB treatment regimens were infrequently used and that ART use and viral suppression was well below the target of 90%, reflecting the challenging patient population and the environment in which health care is provided. Urgent improvement of management of patients with TB/HIV in EE, in particular for those with MDR-TB, is needed and includes widespread access to rapid TB diagnostics, better access to and use of second-line TB drugs, timely ART initiation with viral load monitoring, and integration of TB/HIV care. © 2017 The British Infection Association
title	Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study
title_short	Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study
title_full	Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study
title_fullStr	Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study
title_full_unstemmed	Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study
title_sort	management of mdr-tb in hiv co-infected patients in eastern europe: results from the tb:hiv study
publishDate	2018
url	https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_01634453_v76_n1_p44_Efsen http://hdl.handle.net/20.500.12110/paper_01634453_v76_n1_p44_Efsen
_version_	1768545460639760384

Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB:HIV study

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