ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
Improved Survival and Cure Rates With Concurrent Treatment for Multidrug-Resistant Tuberculosis-Human Immunodeficiency Virus Coinfection in South Africa.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 10 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 10 syntheses or guidelines pooled it.
- A systematic review of risk factors for mortality among tuberculosis patients in South Africa.Systematic reviews · 2023Pooled it
- A systematic review of the quality of conduct and reporting of survival analyses of tuberculosis outcomes in Africa.BMC medical research methodology · 2021Pooled it
- Predictors of mortality in patients with drug-resistant tuberculosis: A systematic review and meta-analysis.PloS one · 2021Pooled it
- Pooled it
- The effects of MDR/RR-TB treatment on HIV disease: A systematic review of literature.PloS one · 2021Pooled it
- Pooled it
- Mortality in adults with multidrug-resistant tuberculosis and HIV by antiretroviral therapy and tuberculosis drug use: an individual patient data meta-analysis.Lancet (London, England) · 2020Pooled it
- Pooled it
- Treatment outcomes and antiretroviral uptake in multidrug-resistant tuberculosis and HIV co-infected patients in Sub Saharan Africa: a systematic review and meta-analysis.BMC infectious diseases · 2019Pooled it
- Factors predictive of the success of tuberculosis treatment: A systematic review with meta-analysis.PloS one · 2019Pooled it
- Exploring HIV disease indicators at MDR-TB treatment initiation in South Africa.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2024Trial
- Tryptophan catabolism reflects disease activity in human tuberculosis.JCI insight · 2020Trial
- A Retrospective Analysis Examining the Impact of Educational Attainment and Social Determinants of Health on Rifampicin-Resistant Tuberculosis Treatment Outcomes.Open forum infectious diseases · 2026Article
- Article
- A Plasma Metabolic Signature to Diagnose Pulmonary Tuberculosis and Monitor Treatment Response.The Journal of infectious diseases · 2025Article
- Midkine (MDK) in cancer and drug resistance: from inflammation to therapy.Discover oncology · 2025Review
- Differentiated service delivery framework for people with multidrug-resistant tuberculosis and HIV co-infection.Journal of acquired immune deficiency syndromes (1999) · 2024Article
- Relationship between HIV viral suppression and multidrug resistant tuberculosis treatment outcomes.PLOS global public health · 2024Article
- What clinic closure reveals about care for drug-resistant TB: a qualitative study.BMC infectious diseases · 2023Article
- Failure or relapse predictors for the STREAM Stage 1 short regimen for RR-TB.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2022Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
Background: Mortality in multidrug-resistant (MDR) tuberculosis-human immunodeficiency virus (HIV) coinfection has historically been high, but most studies predated the availability of antiretroviral therapy (ART). We prospectively compared survival and treatment outcomes in MDR tuberculosis-HIV-coinfected patients on ART to those in patients with MDR tuberculosis alone. Methods: This observational study enrolled culture-confirmed MDR tuberculosis patients with and without HIV in South Africa between 2011 and 2013. Participants received standardized MDR tuberculosis and HIV regimens and were followed monthly for treatment response, adverse events, and adherence. The primary outcome was survival. Results: Among 206 participants, 150 were HIV infected, 131 (64%) were female, and the median age was 33 years (interquartile range [IQR], 26-41). Of the 191 participants with a final MDR tuberculosis outcome, 130 (73%) were cured or completed treatment, which did not differ by HIV status (P = .50). After 2 years, CD4 count increased a median of 140 cells/mm3 (P = .005), and 64% had an undetectable HIV viral load. HIV-infected and HIV-uninfected participants had high rates of survival (86% and 94%, respectively; P = .34). The strongest risk factor for mortality was having a CD4 count ≤100 cells/mm3 (adjusted hazards ratio, 15.6; 95% confidence interval, 4.4-55.6). Conclusions: Survival and treatment outcomes among MDR tuberculosis-HIV individuals receiving concurrent ART approached those of HIV-uninfected patients. The greatest risk of death was among HIV-infected individuals with CD4 counts ≤100 cells/mm3. These findings provide critical evidence to support concurrent treatment of MDR tuberculosis and HIV.
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