2-YEAR FOLLOW-UP OF PERSONS WITH HIV-1-ASSOCIATED AND HIV-2-ASSOCIATED PULMONARY TUBERCULOSIS TREATED WITH SHORT-COURSE CHEMOTHERAPY IN WEST-AFRICA

被引:103
作者
KASSIM, S
SASSANMOROKRO, M
ACKAH, A
ABOUYA, LY
DIGBEU, H
YESSO, G
COULIBALY, IM
COULIBALY, D
WHITAKER, PJ
DOORLY, R
VETTER, KM
BRATTEGAARD, K
GNAORE, E
GREENBERG, AE
WIKTOR, SZ
DECOCK, KM
机构
[1] PROJECT RETRO CI, ABIDJAN, COTE IVOIRE
[2] CTR ANTITUBERCULEUX, ABIDJAN, COTE IVOIRE
[3] CTR DIS CONTROL & PREVENT, NATL CTR INFECT DIS, DIV HIV AIDS, ATLANTA, GA 30333 USA
关键词
WEST AFRICA; TUBERCULOSIS; HIV-1; HIV-2;
D O I
10.1097/00002030-199510000-00011
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
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.
引用
收藏
页码:1185 / 1191
页数:7
相关论文
共 41 条
[1]   RESPONSE TO TREATMENT, MORTALITY, AND CD4 LYMPHOCYTE COUNTS IN HIV-INFECTED PERSONS WITH TUBERCULOSIS IN ABIDJAN, COTE-DIVOIRE [J].
ACKAH, AN ;
COULIBALY, D ;
DIGBEU, H ;
DIALLO, K ;
VETTER, KM ;
COULIBALY, IM ;
GREENBERG, AE ;
DECOCK, KM .
LANCET, 1995, 345 (8950) :607-610
[2]   2-YEAR INCIDENCE OF TUBERCULOSIS IN COHORTS OF HIV-INFECTED AND UNINFECTED URBAN RWANDAN WOMEN [J].
ALLEN, S ;
BATUNGWANAYO, J ;
KERLIKOWSKE, K ;
LIFSON, AR ;
WOLF, W ;
GRANICH, R ;
TAELMAN, H ;
VANDEPERRE, P ;
SERUFILIRA, A ;
BOGAERTS, J ;
SLUTKIN, G ;
HOPEWELL, PC .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1992, 146 (06) :1439-1444
[3]  
[Anonymous], 1993, MMWR Recomm Rep, V42, P1
[4]   TREATMENT OF TUBERCULOSIS AND TUBERCULOSIS INFECTION IN ADULTS AND CHILDREN [J].
BASS, JB ;
FARER, LS ;
HOPEWELL, PC ;
OBRIEN, R ;
JACOBS, RF ;
RUBEN, F ;
SNIDER, DE ;
THORNTON, G .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1994, 149 (05) :1359-1374
[5]   HIV-INFECTION AND PRIMARY RESISTANCE TO ANTITUBERCULOSIS DRUGS IN ABIDJAN, COTE-DIVOIRE [J].
BRAUN, MM ;
KILBURN, JO ;
SMITHWICK, RW ;
COULIBALY, IM ;
COULIBALY, D ;
SILCOX, VA ;
GNAORE, E ;
ADJORLOLO, G ;
DECOCK, KM .
AIDS, 1992, 6 (11) :1327-1330
[6]   A RETROSPECTIVE COHORT STUDY OF THE RISK OF TUBERCULOSIS AMONG WOMEN OF CHILDBEARING AGE WITH HIV-INFECTION IN ZAIRE [J].
BRAUN, MM ;
BADI, N ;
RYDER, RW ;
BAENDE, E ;
MUKADI, Y ;
NSUAMI, M ;
MATELA, B ;
WILLAME, JC ;
KABOTO, M ;
HEYWARD, W .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1991, 143 (03) :501-504
[7]   INFECTION AND MORBIDITY IN PATIENTS WITH TUBERCULOSIS IN NAIROBI, KENYA [J].
BRINDLE, RJ ;
NUNN, PP ;
BATCHELOR, BIF ;
GATHUA, SN ;
KIMARI, JN ;
NEWNHAM, RS ;
WAIYAKI, PG .
AIDS, 1993, 7 (11) :1469-1474
[8]   HIV INFECTION IN PATIENTS WITH TUBERCULOSIS IN KINSHASA, ZAIRE [J].
COLEBUNDERS, RL ;
RYDER, RW ;
NZILAMBI, N ;
DIKILU, K ;
WILLAME, JC ;
KABOTO, M ;
BAGALA, N ;
JEUGMANS, J ;
MUEPU, K ;
FRANCIS, HL ;
MANN, JM ;
QUINN, TC ;
PIOT, P .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1989, 139 (05) :1082-1085
[9]  
COX DR, 1972, J R STAT SOC B, V34, P187
[10]  
CROFTON J, 1992, CLIN TUBERCULOSIS