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M9550852.TXT
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1995-03-25
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Document 0852
DOCN M9550852
TI The impact of human immunodeficiency virus on response to treatment and
recurrence rate in patients treated for tuberculosis: two-year follow-up
of a cohort in Lusaka, Zambia.
DT 9505
AU Elliott AM; Halwiindi B; Hayes RJ; Luo N; Mwinga AG; Tembo G; Machiels
L; Steenbergen G; Pobee JO; Nunn PP; et al; School of Medicine,
University of Zambia, Lusaka.
SO J Trop Med Hyg. 1995 Feb;98(1):9-21. Unique Identifier : AIDSLINE
MED/95165491
AB To examine the effect of HIV on response to treatment and recurrence
rate in patients with tuberculosis (TB), we have followed 239 previously
untreated, adult, TB patients in a prospective cohort study in Lusaka,
Zambia. One hundred and seventy-four (73%) were HIV-1 antibody positive.
Patients with sputum smear positive, miliary, or meningeal TB were
prescribed 2 months daily streptomycin, thiacetazone, isoniazid,
rifampicin, pyrazinamide followed by 6 months thiacetazone and
isoniazid; others, 2 months streptomycin, thiacetazone and isoniazid
followed by 10 months thiacetazone and isoniazid. Thirty-five per cent
of HIV-positive (HIV+ve) and 9% of HIV-negative (HIV-ve) patients were
known to have died before the scheduled end of treatment. Surviving
HIV+ve patients showed weight gain and improvement in symptoms and
laboratory and radiological findings similar to HIV-ve patients. The
risk of cutaneous drug reaction was 17% (95% CI: 12-25%) in HIV+ve, and
4% (1-13%) in HIV-ve patients. Severe rashes were attributed to
thiacetazone. Recurrence of active TB was examined among 64 HIV+ve and
37 HIV-ve patients who successfully completed treatment, with mean
follow-up after the end of treatment of 13.5 and 16.8 months,
respectively. The rate of recurrence was 22/100 person years (pyr) for
HIV+ve patients and 6/100 pyr for HIV-ve patients, giving a recurrence
rate ratio of 4.0 (95% CI 1.2-13.8, P = 0.03).
DE Adult Antitubercular Agents/*THERAPEUTIC USE AIDS-Related
Opportunistic Infections/*DRUG THERAPY Drug Therapy, Combination
Female Follow-Up Studies Human *HIV-1 Male Prospective Studies
Recurrence Support, Non-U.S. Gov't Survival Analysis Treatment
Outcome Tuberculosis/*DRUG THERAPY Urban Health Zambia JOURNAL
ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).