Miliary tuberculosis in human immunodeficiency virus infected patients not on antiretroviral therapy: clinical profile and response to shortcourse chemotherapy.

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dc.contributor.authorSwaminathan, Sen_US
dc.contributor.authorPadmapriyadarsini, Cen_US
dc.contributor.authorPonnuraja, Cen_US
dc.contributor.authorSumathi, C Hen_US
dc.contributor.authorRajasekaran, Sen_US
dc.contributor.authorAmerandran, V Aen_US
dc.contributor.authorReddy, Mvken_US
dc.contributor.authorDeivanayagam, C Nen_US
dc.date.accessioned2007-10-22en_US
dc.date.accessioned2009-06-02T13:03:47Z
dc.date.available2007-10-22en_US
dc.date.available2009-06-02T13:03:47Z
dc.date.issued2007-10-22en_US
dc.description.abstractBACKGROUND: An increase in tuberculosis (TB) incidence has been associated with human immunodeficiency virus (HIV). AIMS: To describe the clinical characteristics and treatment outcome of patients with HIV and miliary TB treated with short-course intermittent chemotherapy in the absence of access to highly active antiretroviral therapy (HAART). SETTINGS AND DESIGN: Prospective study of HIV infected adults referred to a TB clinic between July 1999 and July 2004. MATERIALS AND METHODS: On diagnosis of miliary TB, patients were treated with a standard regimen of two months of isoniazid, rifampicin, ethambutol and pyrazinamide followed by four months of isoniazid and rifampicin (2EHRZ 3 /4RH 3 ) thrice weekly and followed up for 24 months. Patients were reviewed clinically every month and two sputa were collected. Chest radiographs and blood investigations were done at two months, end of treatment and every six months thereafter. RESULTS: Of 498 patients with HIV and tuberculosis, 31 (6%) were diagnosed as miliary tuberculosis. At diagnosis, sputum smear was positive for acid-fast bacilli (AFB) in 14 patients (45%) and Mycobacterium tuberculosis was isolated in 21 (68%). The mean CD4 cell count was 129 +/- 125 cells/mm3 . Twenty-five patients were declared cured at the end of treatment (81%) while one (3%) died and five (16%) failed. The recurrence rate was 19.4/100 person-years and the median survival was 17 months (95% CI 14 to 20). None of the patients received antiretroviral therapy. CONCLUSIONS: Miliary TB tends to occur among HIV infected patients with severe immunosuppression. Though the initial response to short-course chemotherapy was encouraging, a high recurrence rate and mortality was observed indicating poor prognosis in HIV.en_US
dc.description.affiliationTuberculosis Research Centre, Chennai, India. doctorsoumya@yahoo.comen_US
dc.identifier.citationSwaminathan S, Padmapriyadarsini C, Ponnuraja C, Sumathi CH, Rajasekaran S, Amerandran VA, Reddy M, Deivanayagam CN. Miliary tuberculosis in human immunodeficiency virus infected patients not on antiretroviral therapy: clinical profile and response to shortcourse chemotherapy. Journal of Postgraduate Medicine. 2007 Oct-Dec; 53(4): 228-31en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/117336
dc.language.isoengen_US
dc.source.urihttps://www.jpgmonline.comen_US
dc.subject.meshAdulten_US
dc.subject.meshAnti-Retroviral Agentsen_US
dc.subject.meshAntitubercular Agents --administration & dosageen_US
dc.subject.meshCohort Studiesen_US
dc.subject.meshDrug Administration Scheduleen_US
dc.subject.meshFemaleen_US
dc.subject.meshHIV Infections --complicationsen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshRecurrenceen_US
dc.subject.meshTreatment Outcomeen_US
dc.subject.meshTuberculosis, Miliary --complicationsen_US
dc.titleMiliary tuberculosis in human immunodeficiency virus infected patients not on antiretroviral therapy: clinical profile and response to shortcourse chemotherapy.en_US
dc.typeControlled Clinical Trialen_US
dc.typeJournal Articleen_US
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