Undertreated HIV and drug-resistant tuberculosis at a referral hospital in Irkutsk, Siberia

The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease
S K HeysellE R Houpt

Abstract

A referral hospital for tuberculosis (TB) in Irkutsk, the Russian Federation. To describe disease characteristics, treatment and hospital outcomes of TB-HIV (human immunodeficiency virus). Observational cohort of HIV-infected patients admitted for anti-tuberculosis treatment over 6 months. A total of 98 patients were enrolled with a median CD4 count of 147 cells/mm(3) and viral load of 205 943 copies/ml. Among patients with drug susceptibility testing (DST) results, 29 (64%) were multidrug-resistant (MDR), including 12 without previous anti-tuberculosis treatment. Nineteen patients were on antiretroviral therapy (ART) at admission, and 10 (13% ART-naïve) were started during hospitalization. Barriers to timely ART initiation included death, in-patient treatment interruption, and patient refusal. Of 96 evaluable patients, 21 (22%) died, 14 (15%) interrupted treatment, and 10 (10%) showed no microbiological or radiographic improvement. Patients with a cavitary chest X-ray (aOR 7.4, 95%CI 2.3-23.7, P = 0.001) or central nervous system disease (aOR 6.5, 95%CI 1.2-36.1, P = 0.03) were more likely to have one of these poor outcomes. High rates of MDR-TB, treatment interruption and death were found in an HIV-infected population hospita...Continue Reading

Citations

Nov 1, 2011·Infection, Genetics and Evolution : Journal of Molecular Epidemiology and Evolutionary Genetics in Infectious Diseases·Igor Mokrousov
Oct 27, 2011·Infection, Genetics and Evolution : Journal of Molecular Epidemiology and Evolutionary Genetics in Infectious Diseases·Oleg OgarkovEugeniy Savilov
Nov 1, 2016·Antimicrobial Agents and Chemotherapy·Suporn PholwatEric Houpt
Nov 30, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Devyani DeshpandeTawanda Gumbo
Dec 28, 2019·PloS One·Ninfa Marlen Chaves TorresEduardo Martins Netto
Oct 21, 2016·Expert Review of Anti-infective Therapy·Jan-Willem C AlffenaarDick Van Soolingen
Apr 18, 2020·Frontiers in Public Health·Megan E Gray NeilsScott K Heysell

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