Predictors of cure among HIV co-infected multidrug-resistant TB patients at Sizwe Tropical Disease Hospital Johannesburg, South Africa

Transactions of the Royal Society of Tropical Medicine and Hygiene
Teye A UmanahPeter S Nyasulu

Abstract

The global incidence of multidrug-resistant tuberculosis (MDR-TB) is rising, especially among HIV infected patients, despite intervention programs. Limited data are available on outcomes of MDR-TB treatment, specifically in a cohort of HIV co-infected patients in sub-Saharan Africa. The objective of this study was to determine the predictors of cure among MDR-TB HIV co-infected patients. A retrospective review of 1200 medical records of HIV co-infected MDR-TB patients was performed at Sizwe Tropical Disease Hospital, Johannesburg covering the period 2007 to 2010. Logistic regression analysis was done to identify predictors of cure. Of 1137 patients included in the analysis, 29.8% (339/1137) were cured, 16.5% (188/1137) completed treatment, 22.3% (254/1137) defaulted treatment, 2.9% (33/1137) failed treatment and 22.7% (258/1137) died while on treatment. The remaining 5.7% (65/1137) were transferred-out or still-on-treatment. There was a significant interaction between sex and timing of antiretroviral treatment (ART) initiation (p=0.008). Factors predicting cure were male patients on ART prior to commencing MDR-TB treatment (OR 1.87, [1.11-3.13]), CD4(+) cell counts between 201-349 (OR 2.06, [1.10-3.84]) and ≥ 350 cells/mm³ (OR ...Continue Reading

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