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1996-02-27
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Document 0230
DOCN M9630230
TI Two-year follow-up of persons with HIV-1- and HIV-2-associated pulmonary
tuberculosis treated with short-course chemotherapy in West Africa.
DT 9603
AU Kassim S; Sassan-Morokro M; Ackah A; Abouya LY; Digbeu H; Yesso G;
Coulibaly IM; Coulibaly D; Whitaker PJ; Doorly R; et al; Centres
Antituberculeux, Abidjan, Cote d'Ivoire.
SO AIDS. 1995 Oct;9(10):1185-91. Unique Identifier : AIDSLINE MED/96098136
AB OBJECTIVE: To assess the response to therapy for tuberculosis using
rifampicin-containing short-course chemotherapy, and to compare
recurrence and mortality rates in seronegative persons and those with
HIV-1, HIV-2, and dual serologic reactivity in West Africa. METHODS: A
cohort of 835 adult patients (167 HIV-1-positive, 143 HIV-2-positive,
243 dual-reactive, 282 HIV-negative) with smear-positive pulmonary
tuberculosis was followed for 2 years under programme conditions.
Standard self-administered treatment was daily rifampicin and isoniazid
for 6 months, and in addition pyrazinamide during the first 2 months.
Outcomes evaluated were rates of completion of therapy, cure, failure of
treatment, recurrence after cure, and mortality. RESULTS: HIV-positive
patients had lower rates of completion of therapy (65-73%) than
seronegative patients (79%), mainly because of increased mortality.
Among patients completing therapy, failure of treatment was similarly
low in HIV-positive (2%) and seronegative patients (1%). Recurrence
rates after cure did not differ significantly in the 18 months of
follow-up in the four serologic groups (3-7%). The respective mortality
rates for HIV-1-positive, HIV-2-positive, and dually reactive patients
were 20.3, 8.3, and 25.5 per 100 person-years (PY), compared with 2.2
per 100 PY among seronegatives. CONCLUSIONS: Rifampicin-containing
short-course chemotherapy for pulmonary tuberculosis is associated with
similar cure and recurrence rates in HIV-positive and HIV-negative
persons completing 6 months of therapy. HIV-2 infection is associated
with more favourable survival than HIV-1 infection or dual reactivity,
even when AIDS-defining illness is already present. However, mortality
is significantly increased in all seropositive groups compared with
HIV-negative tuberculosis patients; thus, establishing the causes of
this increased mortality is a priority.
DE Adolescence Adult Africa, Western Antibiotics,
Antitubercular/*THERAPEUTIC USE Antitubercular Agents/THERAPEUTIC USE
AIDS-Related Opportunistic Infections/COMPLICATIONS/*DRUG THERAPY/
MORTALITY Drug Therapy, Combination Female Follow-Up Studies Human
HIV Seronegativity HIV Seropositivity/*COMPLICATIONS *HIV-1 *HIV-2
Isoniazid/THERAPEUTIC USE Male Pyrazinamide/THERAPEUTIC USE
Recurrence Rifampin/*THERAPEUTIC USE Treatment Failure Tuberculosis,
Pulmonary/COMPLICATIONS/*DRUG THERAPY/MORTALITY CLINICAL TRIAL JOURNAL
ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).