Cargando…
Clinical profile & predictors of poor outcome of adult HIV-tuberculosis patients in a tertiary care centre in north India
BACKGROUND & OBJECTIVES: There is a paucity of data from India on response to treatment of tuberculosis (TB) in patients with human immunodeficiency virus (HIV)-TB co-infection. This study was done to assess the frequency and pattern of TB, outcome of anti-tuberculosis treatment, and the factors...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2014
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3994731/ https://www.ncbi.nlm.nih.gov/pubmed/24604050 |
_version_ | 1782312783436578816 |
---|---|
author | Sharma, Surendra K. Soneja, Manish Prasad, K. T. Ranjan, Sanjay |
author_facet | Sharma, Surendra K. Soneja, Manish Prasad, K. T. Ranjan, Sanjay |
author_sort | Sharma, Surendra K. |
collection | PubMed |
description | BACKGROUND & OBJECTIVES: There is a paucity of data from India on response to treatment of tuberculosis (TB) in patients with human immunodeficiency virus (HIV)-TB co-infection. This study was done to assess the frequency and pattern of TB, outcome of anti-tuberculosis treatment, and the factors related to poor outcome of TB treatment in adult patients with HIV infection. METHODS: Retrospective review of case records of HIV-TB co-infected patients attending the antiretroviral therapy (ART) clinic in a tertiary care centre in north India was done. RESULTS: Of the 1754 patients included in the study, 583 (33.2%) were diagnosed with active TB and 466 (79.9%) of them had CD4 count less than 200/μl at diagnosis. Extrapulmonary TB was diagnosed in 372 (63.8%) patients [76 (20.4%) had disseminated TB], and pulmonary TB in 211 (36.2%) patients. Favourable outcome (cure and completed treatment) was observed in 332 (77%) patients. Unfavourable outcome included default (8.1%), treatment failure (1.6%), and death (13.2%). At 1-year post-treatment follow up, 12 (3.6%) patients had disease relapse. CD4 count of less than 200/μl at diagnosis [OR-2.32, CI (1.06-5.09)], and retreatment cases [OR-2.91, CI (1.22-6.89)] were independent predictors of unfavourable outcome. INTERPRETATION & CONCLUSIONS: There is an urgent need to strengthen the information, education, communication activities and expand the ART services to meet the requirement of early testing and treatment initiation in patients co-infected with HIV-TB. The findings highlight the need for performing drug susceptibility testing (DST) for patients starting retreatment regimen to improve treatment outcome. |
format | Online Article Text |
id | pubmed-3994731 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-39947312014-04-23 Clinical profile & predictors of poor outcome of adult HIV-tuberculosis patients in a tertiary care centre in north India Sharma, Surendra K. Soneja, Manish Prasad, K. T. Ranjan, Sanjay Indian J Med Res Original Article BACKGROUND & OBJECTIVES: There is a paucity of data from India on response to treatment of tuberculosis (TB) in patients with human immunodeficiency virus (HIV)-TB co-infection. This study was done to assess the frequency and pattern of TB, outcome of anti-tuberculosis treatment, and the factors related to poor outcome of TB treatment in adult patients with HIV infection. METHODS: Retrospective review of case records of HIV-TB co-infected patients attending the antiretroviral therapy (ART) clinic in a tertiary care centre in north India was done. RESULTS: Of the 1754 patients included in the study, 583 (33.2%) were diagnosed with active TB and 466 (79.9%) of them had CD4 count less than 200/μl at diagnosis. Extrapulmonary TB was diagnosed in 372 (63.8%) patients [76 (20.4%) had disseminated TB], and pulmonary TB in 211 (36.2%) patients. Favourable outcome (cure and completed treatment) was observed in 332 (77%) patients. Unfavourable outcome included default (8.1%), treatment failure (1.6%), and death (13.2%). At 1-year post-treatment follow up, 12 (3.6%) patients had disease relapse. CD4 count of less than 200/μl at diagnosis [OR-2.32, CI (1.06-5.09)], and retreatment cases [OR-2.91, CI (1.22-6.89)] were independent predictors of unfavourable outcome. INTERPRETATION & CONCLUSIONS: There is an urgent need to strengthen the information, education, communication activities and expand the ART services to meet the requirement of early testing and treatment initiation in patients co-infected with HIV-TB. The findings highlight the need for performing drug susceptibility testing (DST) for patients starting retreatment regimen to improve treatment outcome. Medknow Publications & Media Pvt Ltd 2014-01 /pmc/articles/PMC3994731/ /pubmed/24604050 Text en Copyright: © Indian Journal of Medical Research http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Sharma, Surendra K. Soneja, Manish Prasad, K. T. Ranjan, Sanjay Clinical profile & predictors of poor outcome of adult HIV-tuberculosis patients in a tertiary care centre in north India |
title | Clinical profile & predictors of poor outcome of adult HIV-tuberculosis patients in a tertiary care centre in north India |
title_full | Clinical profile & predictors of poor outcome of adult HIV-tuberculosis patients in a tertiary care centre in north India |
title_fullStr | Clinical profile & predictors of poor outcome of adult HIV-tuberculosis patients in a tertiary care centre in north India |
title_full_unstemmed | Clinical profile & predictors of poor outcome of adult HIV-tuberculosis patients in a tertiary care centre in north India |
title_short | Clinical profile & predictors of poor outcome of adult HIV-tuberculosis patients in a tertiary care centre in north India |
title_sort | clinical profile & predictors of poor outcome of adult hiv-tuberculosis patients in a tertiary care centre in north india |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3994731/ https://www.ncbi.nlm.nih.gov/pubmed/24604050 |
work_keys_str_mv | AT sharmasurendrak clinicalprofilepredictorsofpooroutcomeofadulthivtuberculosispatientsinatertiarycarecentreinnorthindia AT sonejamanish clinicalprofilepredictorsofpooroutcomeofadulthivtuberculosispatientsinatertiarycarecentreinnorthindia AT prasadkt clinicalprofilepredictorsofpooroutcomeofadulthivtuberculosispatientsinatertiarycarecentreinnorthindia AT ranjansanjay clinicalprofilepredictorsofpooroutcomeofadulthivtuberculosispatientsinatertiarycarecentreinnorthindia |