Factores asociados con la no realización de la prueba de la tuberculina en una cohorte de pacientes VIH positivos

Díaz, Asunción; Díez, Mercedes; Bleda, María José Castro; Aldámiz, Mikel; Camafort, Mikel; Camino, X; Cepeda, Concepción; Costa, Angela Maria Moura; Ferrero, Oscar; Geijo, Paloma; Iribarren, José Antonio; Moreno, Santiago; Moreno, M.; Labarga, Pablo; Pinilla, Javier; Portu, Joseba; Pulido, Federico; Rosa, Carmen; Santamaría, Juan Miguel; Telenti, Mauricio; Trapiella, Luis; Trastoy, Mónica; Viciana, Pompeyo

doi:10.1016/j.eimc.2009.06.008

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…In fact, what is surprising is that almost 50% of all IDUs initiating TLTBI completed it, a figure similar to what has been found in studies where DOT was used [24,25]. This "good" result is explained by the positive selection that had taken place among the IDUs during the clinical process previous to treatment prescription: IDUs were over-represented among subjects who did not undergo TST [11] and constituted the majority of eligible patients for whom TLTBI was not prescribed (82.6%).…”

Section: Discussionmentioning

confidence: 64%

See 1 more Smart Citation

Eligibility for and outcome of treatment of latent tuberculosis infection in a cohort of HIV-infected people in Spain

Díaz

Díez²,

Bleda

et al. 2010

BMC Infect Dis

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BackgroundPrevious studies have demonstrated the efficacy of treatment for latent tuberculosis infection (TLTBI) in persons infected with the human immunodeficiency virus, but few studies have investigated the operational aspects of implementing TLTBI in the co-infected population.The study objectives were to describe eligibility for TLTBI as well as treatment prescription, initiation and completion in an HIV-infected Spanish cohort and to investigate factors associated with treatment completion.MethodsSubjects were prospectively identified between 2000 and 2003 at ten HIV hospital-based clinics in Spain. Data were obtained from clinical records. Associations were measured using the odds ratio (OR) and its 95% confidence interval (95% CI).ResultsA total of 1242 subjects were recruited and 846 (68.1%) were evaluated for TLTBI. Of these, 181 (21.4%) were eligible for TLTBI either because they were tuberculin skin test (TST) positive (121) or because their TST was negative/unknown but they were known contacts of a TB case or had impaired immunity (60). Of the patients eligible for TLTBI, 122 (67.4%) initiated TLTBI: 99 (81.1%) were treated with isoniazid for 6, 9 or 12 months; and 23 (18.9%) with short-course regimens including rifampin plus isoniazid and/or pyrazinamide. In total, 70 patients (57.4%) completed treatment, 39 (32.0%) defaulted, 7 (5.7%) interrupted treatment due to adverse effects, 2 developed TB, 2 died, and 2 moved away. Treatment completion was associated with having acquired HIV infection through heterosexual sex as compared to intravenous drug use (OR:4.6; 95% CI:1.4-14.7) and with having taken rifampin and pyrazinamide for 2 months as compared to isoniazid for 9 months (OR:8.3; 95% CI:2.7-24.9).ConclusionsA minority of HIV-infected patients eligible for TLTBI actually starts and completes a course of treatment. Obstacles to successful implementation of this intervention need to be addressed.

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Section: Discussionmentioning

confidence: 64%

“…The reasons for not undergoing TST were: test not prescribed by the physician (185 cases), patient's refusal (7 cases), and unknown (3 cases). A detailed account of reasons for non-prescription of TST and of M. tuberculosis prevalence in this cohort has already been published [11,12]. …”

Section: Introductionmentioning

confidence: 99%

Eligibility for and outcome of treatment of latent tuberculosis infection in a cohort of HIV-infected people in Spain

Díaz

Díez²,

Bleda

et al. 2010

BMC Infect Dis

Self Cite

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show abstract

“…Furthermore, there is some concern that treatment of LTBI with isoniazid alone may lead to the development of resistance to this drug (13). Consequently, a low frequency of applying the TST has been observed (14)(15)(16) in patients with HIV/ AIDS, who are therefore not treated for LTBI (17), even though it is a vital measure to prevent tuberculosis in this population (18)(19)(20).…”

Section: Original Researchmentioning

confidence: 99%