ArticleJournal of acquired immune deficiency syndromes (1999)2022
Bedaquiline Adherence Measured by Electronic Dose Monitoring Predicts Clinical Outcomes in the Treatment of Patients With Multidrug-Resistant Tuberculosis and HIV/AIDS.
Article in Journal of acquired immune deficiency syndromes (1999), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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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
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Prevalence of bedaquiline resistance in patients with drug-resistant tuberculosis: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Trial
- Rapid detection of treatment-emergent resistance to bedaquiline and pretomanid inMicrobiology spectrum · 2026Article
- Non-Adherence to Anti-Tuberculosis Treatment and Its Determinants Among Tuberculosis Patients in Tanzania.Journal of community health · 2026Article
- Early adherence predicts treatment outcomes and mortality in people living with HIV and multidrug-resistant tuberculosis.Annals of epidemiology · 2026Article
- Socio-ecological vulnerability subgroups predict adherence and treatment outcomes in multidrug-resistant tuberculosis and HIV: a latent class analysis.BMC infectious diseases · 2026Article
- Bedaquiline Resistance in Drug-Resistant Tuberculosis in South Africa: A Systematic Review and Meta-Analysis of Emerging Trends.Antibiotics (Basel, Switzerland) · 2026Review
- Experiences of key populations in multidrug-resistant TB and HIV.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2025Article
- Implementation outcomes of tuberculosis digital adherence technologies: a scoping review using the RE-AIM framework.BMJ global health · 2025Article
- Differentiated service delivery framework for people with multidrug-resistant tuberculosis and HIV co-infection.Journal of acquired immune deficiency syndromes (1999) · 2024Article
- Article
- Therapeutic Failure and Acquired Bedaquiline and Delamanid Resistance in Treatment of Drug-Resistant TB.Emerging infectious diseases · 2023Article
Corrections and comments
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Authors and funding
13 authors at 9 institutions in 4 countries.
Funding
Abstract
backgroundNovel regimens have revolutionized multidrug-resistant tuberculosis (MDR-TB) treatment; however, medication adherence remains challenging and poorly characterized. We hypothesized that bedaquiline adherence, measured using electronic dose monitoring, would predict MDR-TB treatment outcomes.
settingThis is a prospective cohort study conducted in KwaZulu-Natal, South Africa.
methodsAdults with MDR-TB and HIV initiating bedaquiline and on antiretroviral therapy (ART) were eligible. Separate electronic dose monitoring devices measured bedaquiline and ART adherence through 6 months, calculated as observed versus expected doses. Whole-genome sequencing was performed to identify bedaquiline resistance-associated variants.
resultsFrom November 2016 through February 2018, 199 participants with MDR-TB and HIV were enrolled and followed up through treatment completion (median 17.2 months interquartile range 12.2-19.6). The median bedaquiline adherence was higher than ART adherence (97 vs. 89%, P < 0.001) but correlated (r2 = 0.68, P < 0.001). High bedaquiline adherence (≥90%) compared with lower adherence was associated with improved end of treatment successful outcome (83.4% vs. 46.3%, P < 0.001), decreased mortality (11.0% vs. 29.6% P = 0.004), and improved retention in care through end of treatment (94.5% vs. 79.6% P = 0.002). Modeling identified a highly significant but linear association between bedaquiline adherence and outcome. On multivariable analysis, bedaquiline adherence was independently associated with mortality and outcome. Bedaquiline resistance-associated variants were seen in 12% (7/57) of sequenced isolates (7% baseline, 5% emergent) with only 28.6% experiencing successful treatment outcome.
conclusionsBedaquiline adherence through 6 months independently predicted end of MDR-TB treatment outcome, but a specific bedaquiline adherence threshold was not identified. Interventions to optimize bedaquiline adherence are urgently needed to improve MDR-TB HIV treatment outcomes.
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