Please use this identifier to cite or link to this item:
|Title:||Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB: HIV study|
|Author:||Efsen, Anne Marie W.|
Miller, Robert F.
Podlekareva, Daria N.
Miró Meda, José M.
Losso, Marcelo H.
Caylà i Buqueras, Joan A.
Lundgren, Jens D.
Post, Frank A.
Ligero, M. C.
HIV study in EuroCoord
|Keywords:||Infeccions per VIH|
|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: https://doi.org/10.1016/j.jinf.2017.10.007|
|It is part of:||Journal of Infection, 2018, vol. 76, num. 1, p. 44-54|
|Appears in Collections:||Articles publicats en revistes (Medicina)|
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
This item is licensed under a Creative Commons License