Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB: HIV study

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RECERCAT Home > Universitat de Barcelona > IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer > Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) > View document

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dc.contributor.author	Efsen, Anne Marie W.
dc.contributor.author	Schultze, Anna
dc.contributor.author	Miller, Robert F.
dc.contributor.author	Panteleev, Alexander
dc.contributor.author	Skrahin, Aliaksandr
dc.contributor.author	Podlekareva, Daria N.
dc.contributor.author	Miró Meda, José M.
dc.contributor.author	Girardi, Enrico
dc.contributor.author	Furrer, Hansjakob
dc.contributor.author	Losso, Marcelo H.
dc.contributor.author	Toibaro, Javier
dc.contributor.author	Caylà i Buqueras, Joan A.
dc.contributor.author	Mocroft, Amanda
dc.contributor.author	Lundgren, Jens D.
dc.contributor.author	Kirk, Ole
dc.contributor.author	Post, Frank A.
dc.contributor.author	Manzardo, Christian
dc.contributor.author	Ligero, M. C.
dc.contributor.author	González, J.
dc.contributor.author	HIV study in EuroCoord
dc.date	2019-04-03T14:18:23Z
dc.date	2019-04-03T14:18:23Z
dc.date	2018-01
dc.date	2019-04-03T14:18:23Z
dc.identifier	0163-4453
dc.identifier	677524
dc.identifier	29061336
dc.identifier.uri	http://hdl.handle.net/2445/131299
dc.description	Objectives: 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.
dc.format	11 p.
dc.format	application/pdf
dc.language	eng
dc.publisher	Elsevier
dc.relation	Versió postprint del document publicat a: https://doi.org/10.1016/j.jinf.2017.10.007
dc.relation	Journal of Infection, 2018, vol. 76, num. 1, p. 44-54
dc.relation	https://doi.org/10.1016/j.jinf.2017.10.007
dc.relation	info:eu-repo/grantAgreement/EC/FP7/260694/EU//EUROCOORD
dc.rights	cc-by-nc-nd (c) The British Infection Association, 2018
dc.rights	http://creativecommons.org/licenses/by-nc-nd/3.0/es
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	Infeccions per VIH
dc.subject	Tuberculosi
dc.subject	HIV infections
dc.subject	Tuberculosis
dc.title	Management of MDR-TB in HIV co-infected patients in Eastern Europe: Results from the TB: HIV study
dc.type	info:eu-repo/semantics/article
dc.type	info:eu-repo/semantics/acceptedVersion

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