Programmatic treatment outcomes in HIV-infected and uninfected drug-resistant TB patients in Khayelitsha, South Africa
SOURCE: Transactions of the Royal Society of Tropical Medicine and Hygiene
OUTPUT TYPE: Journal Article
PUBLICATION YEAR: 2015
TITLE AUTHOR(S): E.Mohr, V.Cox, L.Wilkinson, S.Moyo, J.Hughes, J.Daniels, O.Muller, H.Cox
KEYWORDS: HIV/AIDS, KHAYELITSHA, TREATMENT CENTRES, TUBERCULOSIS, WESTERN CAPE PROVINCE
DEPARTMENT: Public Health, Societies and Belonging (HSC)
Print: HSRC Library: shelf number 8844
HANDLE: 20.500.11910/1759
URI: http://hdl.handle.net/20.500.11910/1759
OUTPUT TYPE: Journal Article
PUBLICATION YEAR: 2015
TITLE AUTHOR(S): E.Mohr, V.Cox, L.Wilkinson, S.Moyo, J.Hughes, J.Daniels, O.Muller, H.Cox
KEYWORDS: HIV/AIDS, KHAYELITSHA, TREATMENT CENTRES, TUBERCULOSIS, WESTERN CAPE PROVINCE
DEPARTMENT: Public Health, Societies and Belonging (HSC)
Print: HSRC Library: shelf number 8844
HANDLE: 20.500.11910/1759
URI: http://hdl.handle.net/20.500.11910/1759
If you would like to obtain a copy of this Research Output, please contact Hanlie Baudin at researchoutputs@hsrc.ac.za.
Abstract
South Africa has high burdens of HIV, TB and drug-resistant TB (DR-TB, rifampicin-resistance). Treatment outcome data for HIV-infected versus uninfected patients is limited. We assessed the impact of HIV and other factors on DR-TB treatment success, time to culture conversion, loss-from-treatment and overall mortality after second-line treatment initiation. A retrospective cohort analysis was conducted for patients initiated on DR-TB treatment from 2008 to 2012, within a community-based, decentralised programme in Khayelitsha, South Africa. Among 853 confirmed DR-TB patients initiating second-line treatment, 605 (70.9%) were HIV infected. HIV status did not impact on time to sputum culture conversion nor did it impact treatment success; 48.1% (259/539) and 45.9% (100/218), respectively (p=0.59). In a multivariate model, HIV was not associated with treatment success. Death during treatment was higher among HIV-infected patients, but overall mortality was not significantly higher. HIV-infected patients with CD4 100 cells/ml were significantly more likely to die after starting treatment. Response to DR-TB treatment did not differ with HIV infection in a programmatic setting with access to antiretroviral treatment (ART). Earlier ART initiation at a primary care level could reduce mortality among HI infected patients presenting with low CD4 counts.-
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