ArticleThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease2009
Improved early results for patients with extensively drug-resistant tuberculosis and HIV in South Africa.
Article in The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
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Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A systematic review on extensively drug-resistant tuberculosis from 2009 to 2020: special emphases on treatment outcomes.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2023Pooled it
- Comorbidities and treatment outcomes in multidrug resistant tuberculosis: a systematic review and meta-analysis.Scientific reports · 2018Pooled it
- Improved survival in multidrug-resistant tuberculosis patients receiving integrated tuberculosis and antiretroviral treatment in the SAPiT Trial.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2014Trial
- High mortality among patients hospitalized for drug-resistant tuberculosis with acquired second-line drug resistance and high HIV prevalence.HIV medicine · 2022Article
- Bedaquiline Adherence Measured by Electronic Dose Monitoring Predicts Clinical Outcomes in the Treatment of Patients With Multidrug-Resistant Tuberculosis and HIV/AIDS.Journal of acquired immune deficiency syndromes (1999) · 2022Article
- Evolution of drug resistance in Mycobacterium tuberculosis: a review on the molecular determinants of resistance and implications for personalized care.The Journal of antimicrobial chemotherapy · 2018Review
- Do specialist pulmonologists appropriately utilise thoracic surgery for drug-resistant pulmonary tuberculosis? A survey.African journal of thoracic and critical care medicine · 2018Article
- Integrated Tuberculosis/Human Immunodeficiency Virus Community-Based Case Finding in Rural South Africa: Implications for Tuberculosis Control Efforts.Open forum infectious diseases · 2017Article
- A Novel Reporter Phage To Detect Tuberculosis and Rifampin Resistance in a High-HIV-Burden Population.Journal of clinical microbiology · 2015Article
- Special populations and pharmacogenetic issues in tuberculosis drug development and clinical research.The Journal of infectious diseases · 2015Review
- Article
- Clofazimine in the treatment of extensively drug-resistant tuberculosis with HIV coinfection in South Africa: a retrospective cohort study.The Journal of antimicrobial chemotherapy · 2014Article
- Adherence in the treatment of patients with extensively drug-resistant tuberculosis and HIV in South Africa: a prospective cohort study.Journal of acquired immune deficiency syndromes (1999) · 2014Article
- Treatment outcomes of multidrug-resistant tuberculosis patients in Gauteng, South Africa.Infection · 2014Article
- Global control of tuberculosis: from extensively drug-resistant to untreatable tuberculosis.The Lancet. Respiratory medicine · 2014Review
- Health-care workers' perspectives on workplace safety, infection control, and drug-resistant tuberculosis in a high-burden HIV setting.Journal of public health policy · 2013Article
- Treatment outcomes for extensively drug-resistant tuberculosis and HIV co-infection.Emerging infectious diseases · 2013Article
- Article
- What is the cost of diagnosis and management of drug resistant tuberculosis in South Africa?PloS one · 2013Article
- Pulmonary resection for extensively drug resistant tuberculosis in Kwazulu-Natal, South Africa.The Annals of thoracic surgery · 2012Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
settingA public tuberculosis (TB) referral hospital in KwaZulu-Natal, South Africa.
objectiveTo present treatment outcomes of patients with extensively drug-resistant tuberculosis (XDR-TB) patients and human immunodeficiency virus (HIV) coinfection with and without highly active antiretroviral therapy.
methodsRetrospective cohort study. Eligible patients had drug susceptibility testing that met a consensus definition for XDR-TB, and agreed to treatment. Therapy was based on drug susceptibilities, available medications and patient tolerance.
resultsOverall, 60 XDR-TB patients initiated therapy with a median number of 5.5 drugs. Of these, 43 (72%) were HIV-positive, and 21 (49%) were on antiretroviral therapy; 29 HIV-infected patients (67%) had available CD4 counts, with a median CD4 count of 200.5 cells/mm(3) (standard deviation 127.4 cells/mm(3)). Of 60 patients, 31 (52%) had adverse events (AEs), and 17/60 patients (28%) had severe AEs. During follow-up, 12/60 (20%) experienced sputum culture conversion, while 25/60 (42%) patients died. None of the following was significantly associated with mortality: HIV status, previous MDR diagnosis or severe AEs. DISCUSSION: In this study, it was possible to treat HIV-XDR-TB coinfected patients and prolong survival in a resource-limited setting. We highlight the challenges in treatment, including high frequencies of AEs and death. Expanded identification of cases, prompt referral for treatment, and attention to management of comorbidities may facilitate successful treatment of XDR-TB in HIV-infected patients.
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Identifiers
19555535PMC2855970What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.