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1342. Impact of HIV Infection on Treatment Outcome of New Tuberculosis Patients Attending Tuberculosis and Antiretroviral Treatment Services in the Community-Based Hospital, Thailand: A Retrospective Cohort Study
BACKGROUND: Tuberculosis (TB) and HIV are one of the significant public health problems in Thailand, and an estimated 15,000 individuals have a dual infection. Both HIV and TB each disease speeds up the progression of each other. TB is the leading cause of death in HIV-infected individuals, and HIV...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Oxford University Press
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809218/ http://dx.doi.org/10.1093/ofid/ofz360.1206 |
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author | Pinsai, Subencha |
author_facet | Pinsai, Subencha |
author_sort | Pinsai, Subencha |
collection | PubMed |
description | BACKGROUND: Tuberculosis (TB) and HIV are one of the significant public health problems in Thailand, and an estimated 15,000 individuals have a dual infection. Both HIV and TB each disease speeds up the progression of each other. TB is the leading cause of death in HIV-infected individuals, and HIV coinfected TB patients have disease-specific, and treatment affected their treatment outcomes. There is insufficient evidence on issues of TB and HIV co-infection patients received treatment. This study aimed to assess the impact of HIV status on treatment outcome of TB patients. METHODS: We conducted a retrospective cohort study among TB patients who registered to service at Chaophraya Abhaibhubejhr Hospital, Prachin Buri, Thailand from October 1, 2017 to October 31, 2018. All patients’ demographic data, diagnosis, and treatment were retrieved. Clinical characteristics, treatment outcome, and factors associated with treatment outcome were analyzed. RESULTS: There were 49 (10.65%) HIV among 460 TB patients with a median (IQR) age of 44 (32–61) years old and 65.2% were males. Disseminated TB and extrapulmonary TB were higher in HIV coinfected group (P < 0.001). All pulmonary TB patients’ lower lobe involvement was higher in HIV coinfected group (62.50 vs. 36.00, P = 0.001). In HIV coinfected group median CD4 was 134 cell/mm3 (IQR 19–294), 66.67% were diagnosed HIV infection after TB diagnosis, the median time from TB diagnosed to antiretroviral was 29 days (IQR 21–48). The overall treatment success rate was 93.04%; the treatment success rate was similar in HIV coinfected TB patients (89.80%) and non- HIV-infected patients (93.43%) (P = 0.66).Adverse drug reactions were higher in HIV coinfected group (44.89% vs 12.41%) (P < 0.001). By multiple stepwise logistic regression, factors associated with anti-TB drug adverse reactions were having HIV infection (OR 7.99; 95% CI 3.73–17.10, P < 0.001), Age >60 years (OR 2.64; 95% CI 1.43–4.87, P = 0.002) and female sex (OR 1.97; 95% CI 1.11–3.52, P = 0.02). CONCLUSION: There is a high TB treatment success rate among patients who have treated for TB, but adverse drug events in HIV co-infected TB patients is higher than that observed in non-HIV-infected patients. [Image: see text] [Image: see text] [Image: see text] [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. |
format | Online Article Text |
id | pubmed-6809218 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-68092182019-10-28 1342. Impact of HIV Infection on Treatment Outcome of New Tuberculosis Patients Attending Tuberculosis and Antiretroviral Treatment Services in the Community-Based Hospital, Thailand: A Retrospective Cohort Study Pinsai, Subencha Open Forum Infect Dis Abstracts BACKGROUND: Tuberculosis (TB) and HIV are one of the significant public health problems in Thailand, and an estimated 15,000 individuals have a dual infection. Both HIV and TB each disease speeds up the progression of each other. TB is the leading cause of death in HIV-infected individuals, and HIV coinfected TB patients have disease-specific, and treatment affected their treatment outcomes. There is insufficient evidence on issues of TB and HIV co-infection patients received treatment. This study aimed to assess the impact of HIV status on treatment outcome of TB patients. METHODS: We conducted a retrospective cohort study among TB patients who registered to service at Chaophraya Abhaibhubejhr Hospital, Prachin Buri, Thailand from October 1, 2017 to October 31, 2018. All patients’ demographic data, diagnosis, and treatment were retrieved. Clinical characteristics, treatment outcome, and factors associated with treatment outcome were analyzed. RESULTS: There were 49 (10.65%) HIV among 460 TB patients with a median (IQR) age of 44 (32–61) years old and 65.2% were males. Disseminated TB and extrapulmonary TB were higher in HIV coinfected group (P < 0.001). All pulmonary TB patients’ lower lobe involvement was higher in HIV coinfected group (62.50 vs. 36.00, P = 0.001). In HIV coinfected group median CD4 was 134 cell/mm3 (IQR 19–294), 66.67% were diagnosed HIV infection after TB diagnosis, the median time from TB diagnosed to antiretroviral was 29 days (IQR 21–48). The overall treatment success rate was 93.04%; the treatment success rate was similar in HIV coinfected TB patients (89.80%) and non- HIV-infected patients (93.43%) (P = 0.66).Adverse drug reactions were higher in HIV coinfected group (44.89% vs 12.41%) (P < 0.001). By multiple stepwise logistic regression, factors associated with anti-TB drug adverse reactions were having HIV infection (OR 7.99; 95% CI 3.73–17.10, P < 0.001), Age >60 years (OR 2.64; 95% CI 1.43–4.87, P = 0.002) and female sex (OR 1.97; 95% CI 1.11–3.52, P = 0.02). CONCLUSION: There is a high TB treatment success rate among patients who have treated for TB, but adverse drug events in HIV co-infected TB patients is higher than that observed in non-HIV-infected patients. [Image: see text] [Image: see text] [Image: see text] [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6809218/ http://dx.doi.org/10.1093/ofid/ofz360.1206 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Abstracts Pinsai, Subencha 1342. Impact of HIV Infection on Treatment Outcome of New Tuberculosis Patients Attending Tuberculosis and Antiretroviral Treatment Services in the Community-Based Hospital, Thailand: A Retrospective Cohort Study |
title | 1342. Impact of HIV Infection on Treatment Outcome of New Tuberculosis Patients Attending Tuberculosis and Antiretroviral Treatment Services in the Community-Based Hospital, Thailand: A Retrospective Cohort Study |
title_full | 1342. Impact of HIV Infection on Treatment Outcome of New Tuberculosis Patients Attending Tuberculosis and Antiretroviral Treatment Services in the Community-Based Hospital, Thailand: A Retrospective Cohort Study |
title_fullStr | 1342. Impact of HIV Infection on Treatment Outcome of New Tuberculosis Patients Attending Tuberculosis and Antiretroviral Treatment Services in the Community-Based Hospital, Thailand: A Retrospective Cohort Study |
title_full_unstemmed | 1342. Impact of HIV Infection on Treatment Outcome of New Tuberculosis Patients Attending Tuberculosis and Antiretroviral Treatment Services in the Community-Based Hospital, Thailand: A Retrospective Cohort Study |
title_short | 1342. Impact of HIV Infection on Treatment Outcome of New Tuberculosis Patients Attending Tuberculosis and Antiretroviral Treatment Services in the Community-Based Hospital, Thailand: A Retrospective Cohort Study |
title_sort | 1342. impact of hiv infection on treatment outcome of new tuberculosis patients attending tuberculosis and antiretroviral treatment services in the community-based hospital, thailand: a retrospective cohort study |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809218/ http://dx.doi.org/10.1093/ofid/ofz360.1206 |
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