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relapse of TB in HIV

Amanda McIvor, Hendrik Koornhof, Bavesh Davandra Kana
Tuberculosis (TB) disease can be characterized by genotypic and phenotypic complexity in Mycobacterium tuberculosis bacilli within a single patient. This microbiological heterogeneity has become an area of intense study due its perceived importance in drug tolerance, drug resistance and as a surrogate measure of transmission rates. This review presents a descriptive analysis of research describing the prevalence of mixed-strain TB infections in geographically distinct locations. Despite significant variation in disease burden and a rampant human immunodeficiency virus (HIV)-TB co-epidemic, there was no difference in the prevalence range of mixed infections reported in African countries when compared to the rest of the world...
April 1, 2017: Pathogens and Disease
Simon Tiberi, Anna Cristina C Carvalho, Giorgia Sulis, Devan Vaghela, Adrian Rendon, Fernanda C de Q Mello, Ananna Rahman, Nashaba Matin, Ali Zumla, Emanuele Pontali
The tuberculosis (TB) and HIV syndemic continues to rage and are a major public health concern worldwide. This deadly association raises complexity and represent a significant barrier towards TB elimination. TB continues to be the leading cause of death amongst HIV-infected people. This paper reports the challenges that lay ahead and outlines some of the current and future strategies that may be able to address this co-epidemic efficiently. Improved diagnostics, cheaper and more effective drugs, shorter treatment regimens for both drug-sensitive and drug-resistant TB are discussed...
March 2017: La Presse Médicale
Mehdi Kazempour Dizaji, Anoshirvan Kazemnejad, Payam Tabarsi, Farid Zayeri
INTRODUCTION: Although tuberculosis (TB) is curable, the rate of failure and mortality is high in comparison to other infectious diseases worldwide. It has been shown that majority of TB patients leave treatment before completing the therapeutic regimen. The aftermath of incomplete regimens might result in drug resistant-TB bacilli (DR-TB), relapses, and death. For this reason, proper knowledge about the disease and associated risk factor is crucial to decreasing TB cases among the general population...
December 2016: International Journal of Mycobacteriology
Renata Báez-Saldaña, Guadalupe Delgado-Sánchez, Lourdes García-García, Luis Pablo Cruz-Hervert, Marlene Montesinos-Castillo, Leticia Ferreyra-Reyes, Miriam Bobadilla-Del-Valle, Sergio Canizales-Quintero, Elizabeth Ferreira-Guerrero, Norma Téllez-Vázquez, Rogelio Montero-Campos, Mercedes Yanes-Lane, Norma Mongua-Rodriguez, Rosa Areli Martínez-Gamboa, José Sifuentes-Osornio, Alfredo Ponce-de-León
BACKGROUND: Isoniazid mono-resistance (IMR) is the most common form of mono-resistance; its world prevalence is estimated to range between 0.0 to 9.5% globally. There is no consensus on how these patients should be treated. OBJECTIVE: To describe the impact of IMR tuberculosis (TB) on treatment outcome and survival among pulmonary TB patients treated under programmatic conditions in Orizaba, Veracruz, Mexico. MATERIALS AND METHODS: We conducted a prospective cohort study of pulmonary TB patients in Southern Mexico...
2016: PloS One
Maria Korzeniewska-Koseła
AIM OF THE STUDY: To evaluate the main features of TB epidemiology in 2014 in Poland and to compare with the data on the same phenomena in EU/EEA countries. METHODS: Analysis of case- based data on TB patients from National TB Register, data on anti-TB drugsusceptibility testing results in cases notified in 2014, data from National Institute of Public Health- NationalInstitute of Hygiene on cases of tuberculosis as AIDS-defining disease, data from Central Statistical Office ondeaths from tuberculosis based on death certificates, data from ECDC report „ European Centre for DiseasePrevention and Control/WHO Regional Office for Europe...
2016: Przegla̧d Epidemiologiczny
Sophie Jullien, Siddharth Jain, Hannah Ryan, Vineet Ahuja
BACKGROUND: Tuberculosis (TB) of the gastrointestinal tract and any other organ within the abdominal cavity is abdominal TB, and most guidelines recommend the same six-month regimen used for pulmonary TB for people with this diagnosis. However, some physicians are concerned whether a six-month treatment regimen is long enough to prevent relapse of the disease, particularly in people with gastrointestinal TB, which may sometimes cause antituberculous drugs to be poorly absorbed. On the other hand, longer regimens are associated with poor adherence, which could increase relapse, contribute to drug resistance developing, and increase costs to patients and health providers...
November 1, 2016: Cochrane Database of Systematic Reviews
Prerna K Chawla, Zarir F Udwadia, Rajeev Soman, Ashok A Mahashur, Rohit A Amale, Alpa J Dherai, Rohan V Lokhande, Prasad R Naik, Tester F Ashavaid
Therapeutic Drug Monitoring (TDM) is a routinely practised clinical laboratory technique which aids the clinicians with a clear clinical judgement of the drug therapy and optimize the doses if necessary. Rifampicin is the most important and potent component of first line therapy of tuberculosis (TB). Several factors like age, weight, gender, doses and formulations, gastro-intestinal disorders, ethnicity etc alter the absorption and bioavailability of rifampicin thus altering the drug levels. Low plasma levels of rifampicin may play a plausible role in slow response to therapy, treatment failure or relapse or acquired drug resistance...
August 2016: Journal of the Association of Physicians of India
Zoë M McLaren, Amanda A Milliken, Amanda J Meyer, Alana R Sharp
BACKGROUND: Tuberculosis (TB) now ranks alongside HIV as the leading infectious disease cause of death worldwide and incurs a global economic burden of over $12 billion annually. Directly observed therapy (DOT) recommends that TB patients complete the course of treatment under direct observation of a treatment supporter who is trained and overseen by health services to ensure that patients take their drugs as scheduled. Though the current WHO End TB Strategy does not mention DOT, only "supportive treatment supervision by treatment partners", many TB programs still use it despite the fact that the has not been demonstrated to be statistically significantly superior to self-administered treatment in ensuring treatment success or cure...
October 4, 2016: BMC Infectious Diseases
Enos O Masini, Omar Mansour, Clare E Speer, Vittorio Addona, Christy L Hanson, Joseph K Sitienei, Hillary K Kipruto, Martin Muhingo Githiomi, Brenda Nyambura Mungai
Despite high tuberculosis (TB) treatment success rate, treatment adherence is one of the major obstacles to tuberculosis control in Kenya. Our objective was to identify patient-related factors that were associated with time to TB treatment interruption and the geographic distribution of the risk of treatment interruption by county. Data of new and retreatment patients registered in TIBU, a Kenyan national case-based electronic data recording system, between 2013 and 2014 was obtained. Kaplan-Meier curves and log rank tests were used to assess the adherence patterns...
2016: PloS One
Omar Salad Elmi, Habsah Hasan, Sarimah Abdullah, Mat Zuki Mat Jeab, Zilfalil Ba, Nyi Nyi Naing
BACKGROUND: Treating patients with multidrug-resistant tuberculosis (MDR-TB) strains is more complicated, complex, toxic, expensive, than treating patients with susceptible TB strains. This study aims to compare the treatment outcomes and potential factors associated between patients with MDR-TB and non MDR TB infections in peninsular Malaysia. METHODS: This study was a retrospective cohort study. Data were collected from the medical records of all registered MDR-TB patients and Non-MDR-TB patients at five TB hospitals in peninsular Malaysia from January 2010 to January 2014...
July 2016: Malaysian Journal of Medical Sciences: MJMS
J D Jenks, N Kumarasamy, C Ezhilarasi, S Poongulali, P Ambrose, T Yepthomi, C Devaraj, C A Benson
SETTING: Y R Gaitonde Centre for AIDS Research and Education, Chennai, India. OBJECTIVE: To compare anti-tuberculosis treatment outcomes in individuals with human immunodeficiency virus (HIV) and tuberculosis (TB) co-infection on atazanavir/ritonavir (ATV/r) antiretroviral therapy (ART) plus daily rifabutin (RBT) 150 mg with those on ATV/r plus thrice-weekly RBT 150 mg. DESIGN: A retrospective study was conducted of two HIV-TB co-infected cohorts between 2003 and 2014...
September 2016: International Journal of Tuberculosis and Lung Disease
Tom Hiatt, Nobuyuki Nishikiori
INTRODUCTION: Since the year 2000, tuberculosis (TB) prevalence in the World Health Organization (WHO) Western Pacific Region decreased 36%. However, there were an estimated 1.6 million TB cases in the Region in 2013. This study describes a regional analysis using the WHO global TB database data from 2000 to 2013. METHODS: TB surveillance data are annually collected from 36 countries and areas in the Western Pacific Region using a web-based system. TB case notifications, treatment outcomes and information on TB/HIV coinfection are analysed descriptively...
April 2016: Western Pacific Surveillance and Response Journal: WPSAR
Vania Celina Dezoti Micheletti, Afrânio Lineu Kritski, José Ueleres Braga
PURPOSE: To evaluate the clinical features and treatment outcomes of patients with pulmonary tuberculosis, stratified by level of drug resistance. METHODS: This was a historical cohort study based on data from the II National Anti-Tuberculosis Drug Resistance Survey (2006-2007) collected at eight participating health care facilities in Porto Alegre, southern Brazil. The cohort was followed for 3 years after the start of treatment. RESULTS: Of 299 cases of smear-positive pulmonary tuberculosis included in the study, 216 (72...
2016: PloS One
Mehdi Kazempour-Dizaji, Anoshirvan Kazemnejad, Payam Tabarsi, Farid Zayeri
BACKGROUND: Tuberculosis (TB) is a chronic bacterial disease, which despite the presence of effective drug strategies, still remains a serious health problem worldwide. Estimation of survival rate is an appropriate indicator for prognosis in patients with pulmonary TB. Therefore, this research was designed with the aim of accurate estimation of the survival of patients by taking both the death event and relapse into consideration. MATERIALS AND METHODS: Based on a retrospective cohort study, information of 2,299 patients with pulmonary TB that had been referred to and treated in Masih Daneshvari Hospital from 2005 to 2015 was reviewed...
2016: Tanaffos
Carmen R Gallardo, David Rigau Comas, Angélica Valderrama Rodríguez, Marta Roqué i Figuls, Lucy Anne Parker, Joan Caylà, Xavier Bonfill Cosp
BACKGROUND: People who are newly diagnosed with pulmonary tuberculosis (TB) typically receive a standard first-line treatment regimen that consists of two months of isoniazid, rifampicin, pyrazinamide, and ethambutol followed by four months of isoniazid and rifampicin. Fixed-dose combinations (FDCs) of these drugs are widely recommended. OBJECTIVES: To compare the efficacy, safety, and acceptability of anti-tuberculosis regimens given as fixed-dose combinations compared to single-drug formulations for treating people with newly diagnosed pulmonary tuberculosis...
2016: Cochrane Database of Systematic Reviews
Naira Dekhil, Nedra Meftahi, Besma Mhenni, Saloua Ben Fraj, Raja Haltiti, Sameh Belhaj, Helmi Mardassi
BACKGROUND: Multidrug-resistant tuberculosis (MDR-TB) outbreaks that evolve, from the outset, in a context strictly negative for HIV infection deserve special consideration since they reflect the true intrinsic epidemic potential of the causative strain. To our knowledge, the long-term evolution of such exceptional outbreaks and the treatment outcomes for the involved patients has never been reported hitherto. Here we provide a thorough description, over an 11-year period, of an MDR-TB outbreak that emerged and expanded in an HIV-negative context, Northern Tunisia...
2016: PloS One
Serge Ade, Omer Adjibodé, Prudence Wachinou, Narcisse Toundoh, Bérénice Awanou, Gildas Agodokpessi, Dissou Affolabi, Gabriel Adè, Anthony D Harries, Séverin Anagonou
Objective. To determine among retreatment tuberculosis patients in Benin baseline characteristics, culture, and drug sensitivity testing (DST) results and treatment outcomes. Materials and Methods. A retrospective national cohort study of all retreatment tuberculosis patients in Benin in 2013 using registers and treatment cards. Results. Of 3957 patients with tuberculosis, 241 (6%) were retreatment cases. Compared to new pulmonary bacteriologically confirmed tuberculosis (NPBCT) patients, there were significantly higher numbers of males (P = 0...
2016: Tuberculosis Research and Treatment
Simon Pollett, Pamela Banner, Matthew V N O'Sullivan, Anna P Ralph
OBJECTIVES: Extra-pulmonary tuberculosis (EPTB) is relatively neglected and increasing in incidence, in comparison to pulmonary tuberculosis (PTB) in low-burden settings. It poses particular diagnostic and management challenges. We aimed to determine the characteristics of EPTB in Western Sydney, Australia, and to conduct a quality assurance investigation of adherence to guidelines among Infectious Diseases (ID) practitioners managing EPTB cases. METHODS: All adult EPTB cases managed by a large ID service during 01/01/2008-31/12/2011 were eligible for inclusion in the retrospective review...
2016: PloS One
Nathália Mota de Faria Gomes, Meire Cardoso da Mota Bastos, Renata Magliano Marins, Aline Alves Barbosa, Luiz Clóvis Parente Soares, Annelise Maria de Oliveira Wilken de Abreu, João Tadeu Damian Souto Filho
OBJECTIVES: To identify the risk factors that were associated with abandonment of treatment and mortality in tuberculosis (TB) patients. METHODS: This study was a retrospective longitudinal cohort study involving tuberculosis patients treated between 2002 and 2008 in a TB reference center. RESULTS: A total of 1,257 patients were evaluated, with 69.1% men, 54.4% under 40 years of age, 18.9% with extrapulmonary disease, and 9.3% coinfected with HIV...
2015: Pulmonary Medicine
E dos Santos Dias, T N do Prado, A L da Silva Guimarães, M C Ramos, C M M Sales, E de Fátima Almeida Lima, C C Sant'Anna, M Sanchez, E L Maciel
SETTING: Human immunodeficiency virus (HIV) infection may impact tuberculosis (TB) diagnosis, clinical presentation and treatment outcomes in children as the signs and symptoms of both diseases overlap. OBJECTIVE: To compare the sociodemographic and clinical profiles of childhood TB according to HIV status in Brazil. METHODS: This was a cross-sectional study of data on subjects aged <15 years retrieved from the Brazilian National Electronic Disease Registry (Sistema de Informação de Agravos de Notificação) database on TB to compare TB-HIV coinfected patients and patients with TB only registered between 2007 and 2011...
November 2015: International Journal of Tuberculosis and Lung Disease
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