Efsen, Anne Marie W.Schultze, AnnaMiller, Robert F.Panteleev, AlexanderSkrahin, AliaksandrPodlekareva, Daria N.Miró Meda, José M. (José María), 1956-Girardi, EnricoFurrer, HansjakobLosso, Marcelo H.Toibaro, JavierCaylà i Buqueras, Joan A.Mocroft, AmandaLundgren, Jens D.Kirk, OlePost, Frank A.Manzardo, ChristianLigero, M. C.González, J.HIV study in EuroCoord2019-04-032019-04-032018-010163-4453https://hdl.handle.net/2445/131299Objectives: 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.11 p.application/pdfengcc-by-nc-nd (c) The British Infection Association, 2018http://creativecommons.org/licenses/by-nc-nd/3.0/esInfeccions per VIHTuberculosiHIV infectionsTuberculosisinfo:eu-repo/semantics/article6775242019-04-03info:eu-repo/semantics/openAccess29061336