Long term follow up of HIV-infected patients with tuberculosis treated with 6-month intermittent short course chemotherapy.

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dc.contributor.authorSwaminathan, Soumyaen_US
dc.contributor.authorDeivanayagam, C Nen_US
dc.contributor.authorRajasekaran, Sen_US
dc.contributor.authorVenkatesan, Pen_US
dc.contributor.authorPadmapriyadarsini, Cen_US
dc.contributor.authorMenon, Pradeep Aen_US
dc.contributor.authorPonnuraja, Cen_US
dc.contributor.authorDilip, Meenalochanien_US
dc.date.accessioned2008-01-14en_US
dc.date.accessioned2009-06-03T06:50:05Z
dc.date.available2008-01-14en_US
dc.date.available2009-06-03T06:50:05Z
dc.date.issued2008-01-14en_US
dc.description.abstractBACKGROUND: Tuberculosis occurs in 60%-70% of HIV-positive persons in India. The outcome of HIV-positive patients treated with 6-month intermittent short course antituberculosis regimens in India is not well described. METHODS: This was a prospective observational feasibility study of 71 patients with HIV and tuberculosis who were treated with category I regimen of the Revised National Tuberculosis Control Programme (ethambutol, isoniazid, rifampicin and pyrazinamide thrice weekly for the initial 2 months followed by rifampicin and isoniazid thrice weekly for the next 4 months). Sputum was examined by smear and culture for Mycobacterium tuberculosis every month up to 24 months. Chest X-ray, CD4 cell count and viral load were done prior to and at the end of treatment. None of the patients received antiretroviral therapy. RESULTS: We present here the treatment response of patients with sputum culture-positive pulmonary tuberculosis to category I regimen. By efficacy analysis, among 43 patients treated with category I regimen, sputum smear conversion was observed in 79% and culture conversion in 82% at the second month. A favourable response was seen in 72% of patients. The mean (SD) CD4% fell from 12.6 (5.9) to 8.9 (4.9) (p < 0.001) with no significant change in mean (SD) CD4 cell count (169 [126] to 174 [158]; ns) at the end of treatment. Viral load change from 1.8 x 10(5) at baseline to 1.3 x 10(5) at the end of treatment was not statistically significant. Thirty-one patients, who completed the full course of treatment, were declared cured and were followed up for 24 months. Twelve had recurrent tuberculosis (39%); 16 of 43 (37%) patients had died by the end of 24 months, two-thirds due to causes other than tuberculosis. CONCLUSION: Though the early bacteriological response to intermittent short course antituberculosis regimen was satisfactory, the overall outcome was adversely affected by the high mortality (during and after completion of treatment) and recurrence rate among HIV-infected patients with tuberculosis. Immune status deteriorated in spite of antituberculosis treatment, highlighting the need for antiretroviral treatment in addition to antituberculosis treatment to improve the long term outcome. The results of this pilot study need to be confirmed by larger studies.en_US
dc.description.affiliationTuberculosis Research Centre, Mayor V R Ramanathan Road, Chetput, Chennai 600031, Tamil Nadu, India. doctorsoumya@yahoo.comen_US
dc.identifier.citationSwaminathan S, Deivanayagam CN, Rajasekaran S, Venkatesan P, Padmapriyadarsini C, Menon PA, Ponnuraja C, Dilip M. Long term follow up of HIV-infected patients with tuberculosis treated with 6-month intermittent short course chemotherapy. National Medical Journal of India. 2008 Jan-Feb; 21(1): 3-8en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/119308
dc.language.isoengen_US
dc.source.urihttps://www.nmji.inen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAntitubercular Agents --therapeutic useen_US
dc.subject.meshCD4 Lymphocyte Counten_US
dc.subject.meshEthambutol --therapeutic useen_US
dc.subject.meshFeasibility Studiesen_US
dc.subject.meshFemaleen_US
dc.subject.meshHIV Infections --complicationsen_US
dc.subject.meshHumansen_US
dc.subject.meshIndiaen_US
dc.subject.meshIsoniazid --therapeutic useen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMycobacterium tuberculosisen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshPyrazinamide --therapeutic useen_US
dc.subject.meshRecurrenceen_US
dc.subject.meshRifampin --therapeutic useen_US
dc.subject.meshTreatment Outcomeen_US
dc.subject.meshTuberculosis --diagnosisen_US
dc.titleLong term follow up of HIV-infected patients with tuberculosis treated with 6-month intermittent short course chemotherapy.en_US
dc.typeJournal Articleen_US
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