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http://hdl.handle.net/2445/99640
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DC Field | Value | Language |
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dc.contributor.author | Efsen, Anne Marie W. | - |
dc.contributor.author | Schultze, Anna | - |
dc.contributor.author | Post, Frank A. | - |
dc.contributor.author | Panteleev, Alexander | - |
dc.contributor.author | Furrer, Hansjakob | - |
dc.contributor.author | Miller, Robert F. | - |
dc.contributor.author | Losso, Marcelo H. | - |
dc.contributor.author | Toibaro, Javier | - |
dc.contributor.author | Skrahin, Aliaksandr | - |
dc.contributor.author | Miró Meda, José M. | - |
dc.contributor.author | Caylà i Buqueras, Joan A. | - |
dc.contributor.author | Girardi, Enrico | - |
dc.contributor.author | Bruyand, Mathias | - |
dc.contributor.author | Obel, Niels | - |
dc.contributor.author | Podlekareva, Daria N. | - |
dc.contributor.author | Lundgren, Jens D. | - |
dc.contributor.author | Mocroft, Amanda | - |
dc.contributor.author | Kirk, Ole | - |
dc.contributor.author | Alcaide Fernández de Vega, Fernando | - |
dc.contributor.author | TB:HIV study group in EuroCoord | - |
dc.date.accessioned | 2016-06-20T07:36:19Z | - |
dc.date.available | 2016-06-20T07:36:19Z | - |
dc.date.issued | 2015-12-30 | - |
dc.identifier.issn | 1932-6203 | - |
dc.identifier.uri | http://hdl.handle.net/2445/99640 | - |
dc.description.abstract | Objectives: rates of TB/HIV coinfection and multi-drug resistant (MDR)-TB are increasing in Eastern Europe (EE). We aimed to study clinical characteristics, factors associated with MDR-TB and predicted activity of empiric anti-TB treatment at time of TB diagnosis among TB/HIV coinfected patients in EE, Western Europe (WE) and Latin America (LA). Design and methods: between January 1, 2011, and December 31, 2013, 1413 TB/HIV patients (62 clinics in 19 countries in EE, WE, Southern Europe (SE), and LA) were enrolled. Results: significant differences were observed between EE (N = 844), WE (N = 152), SE (N = 164), and LA (N = 253) in the proportion of patients with a definite TB diagnosis (47%, 71%, 72% and 40%, p<0.0001), MDR-TB (40%, 5%, 3% and 15%, p<0.0001), and use of combination antiretroviral therapy (cART) (17%, 40%, 44% and 35%, p<0.0001). Injecting drug use (adjusted OR (aOR) = 2.03 (95% CI 1.00-4.09), prior anti-TB treatment (3.42 (1.88-6.22)), and living in EE (7.19 (3.28-15.78)) were associated with MDR-TB. Among 585 patients with drug susceptibility test (DST) results, the empiric (i.e. without knowledge of the DST results) anti-TB treatment included ≥3 active drugs in 66% of participants in EE compared with 90-96% in other regions (p<0.0001). Conclusions: in EE, TB/HIV patients were less likely to receive a definite TB diagnosis, more likely to house MDR-TB and commonly received empiric anti-TB treatment with reduced activity. Improved management of TB/HIV patients in EE requires better access to TB diagnostics including DSTs, empiric anti-TB therapy directed at both susceptible and MDR-TB, and more widespread use of cART. | - |
dc.format.extent | 17 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | Public Library of Science (PLoS) | - |
dc.relation.isformatof | Reproducció del document publicat a: http://dx.doi.org/10.1371/journal.pone.0145380 | - |
dc.relation.ispartof | PLoS One, 2015, vol. 10, num. 12, p. e0145380 | - |
dc.relation.uri | http://dx.doi.org/10.1371/journal.pone.0145380 | - |
dc.rights | cc-by (c) Efsen, Anne Marie W. et al., 2015 | - |
dc.rights.uri | http://creativecommons.org/licenses/by/3.0/es | - |
dc.source | Articles publicats en revistes (Patologia i Terapèutica Experimental) | - |
dc.subject.classification | Tuberculosi | - |
dc.subject.classification | VIH (Virus) | - |
dc.subject.classification | Infeccions per VIH | - |
dc.subject.classification | Resistència als medicaments | - |
dc.subject.classification | Terapèutica | - |
dc.subject.classification | Europa de l'Est | - |
dc.subject.classification | Europa occidental | - |
dc.subject.classification | Amèrica Llatina | - |
dc.subject.other | Tuberculosis | - |
dc.subject.other | HIV (Viruses) | - |
dc.subject.other | HIV infections | - |
dc.subject.other | Drug resistance | - |
dc.subject.other | Therapeutics | - |
dc.subject.other | Eastern Europe | - |
dc.subject.other | Western Europe | - |
dc.subject.other | Latin America | - |
dc.title | Major Challenges in clinical management of TB/HIV coinfected patients in Eastern Europe compared with Western Europe and Latin America | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.identifier.idgrec | 662116 | - |
dc.date.updated | 2016-06-20T07:36:24Z | - |
dc.relation.projectID | info:eu-repo/grantAgreement/EC/FP7//260694/EU//EUROCOORD | - |
dc.relation.projectID | info:eu-repo/grantAgreement/EC/FP7/V/EU//EUROCOORD | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 26716686 | - |
Appears in Collections: | Articles publicats en revistes (Patologia i Terapèutica Experimental) Articles publicats en revistes (Medicina) Publicacions de projectes de recerca finançats per la UE |
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