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Title: Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB: HIV study
Author: Efsen, Anne Marie W.
Schultze, Anna
Miller, Robert F.
Panteleev, Alexander
Skrahin, Aliaksandr
Podlekareva, Daria N.
Miró Meda, José M.
Girardi, Enrico
Furrer, Hansjakob
Losso, Marcelo H.
Toibaro, Javier
Caylà i Buqueras, Joan A.
Mocroft, Amanda
Lundgren, Jens D.
Kirk, Ole
Post, Frank A.
Manzardo, Christian
Ligero, M. C.
González, J.
HIV study in EuroCoord
Keywords: Infeccions per VIH
HIV infections
Issue Date: Jan-2018
Publisher: Elsevier
Abstract: 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.
Note: Versió postprint del document publicat a:
It is part of: Journal of Infection, 2018, vol. 76, num. 1, p. 44-54
Related resource:
ISSN: 0163-4453
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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