Relapse rates after short-course (6-month) treatment of tuberculosis in HIV-infected and uninfected persons

Abstract

These results support current recommendations to treat tuberculosis in HIV-infected patients with short-course (6-month) therapy.

Treatment Outcomes of Patients with HIV and Tuberculosis

“…Of five prior publications in which recurrence data were compared and reported, none showed a statistically significant difference between HIV-infected and HIV-uninfected/unknown patients (8)(9)(10)(11)(12). The recurrence rate in HIV-infected individuals treated for tuberculosis was around 5% in all of these studies except one, which was located in an area of endemic tuberculosis and reported a high recurrence rate of 9% (11).…”

“…In general, treatment outcomes of conventional 6-month, rifamycin-based regimens for tuberculosis are reported as being equivalent in HIV-infected and HIV-uninfected individuals (7)(8)(9)(10)(11)(12). As a consequence, current guidelines recommend a 6-month, rifamycin-based course for all patients with drugsusceptible tuberculosis regardless of their HIV serostatus (2).…”

In vitroandin vivoanti-Helicobacter/Campylobacteractivity of the aqueous extract ofEnantia chlorantha

“…This is being applied for the treatment of tuberculosis (Sterling et al, 1999) and malaria (Bloland et al, 2000), and for H. pylori eradication (Kato et al, 2000;Beales, 2001). Crude extracts are known to contain several active principles, and as such may be considered as combinations of active principles with potentiating or synergistic effects.…”

Clinical management of tuberculosis and HIV-1 co-infection

“…In Brazil, TB recurrence rates were high in HIV-1 infected persons but if there was completion of initial TB therapy, use of ART and subsequent increases in CD4 cell counts then recurrence rates were low, suggesting re-infection may have been the reason for recurrence [138]. Overall, most studies concur that standard TB treatment should be given to HIV-1 infected patients whenever possible [134,135,139,140]. A 6-month treatment regimen that includes rifampicin and INH throughout should be given for drug-sensitive TB (outside of the central nervous system).…”

“…Some trials suggest that a 6-month short-course therapy is appropriate in HIV-1 [133][134][135], whilst others suggest prolonging the duration to 9 months. A retrospective review from the US showed no treatment failures in HIV-1 infected patients administered a 6 month standard rifampicin-based regimen but relapse rates were four-times higher in those treated for 6 months compared to those treated for longer [136].…”