The effects of MDR/RR-TB treatment on HIV disease: A systematic review of literature

Geiger, Keri; Stamper, Paul D.; Farley, Jason E.

doi:10.1371/journal.pone.0248174

Cited by 6 publications

(11 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[7][8][9][10][11] Evidence on HIV disease indicators following DR-TB treatment is scarce, as highlighted in a systematic review of the effects of DR-TB treatment on HIV disease. 12 Although transmission of DR-TB occurs frequently in TB high-burden settings, 13 drug resistance can also be acquired spontaneously via M. tuberculosis chromosomal mutations followed by anti-TB drug selection. 14 HIV was associated with acquisition of rifampicin resistance during treatment for drug-susceptible TB in a retrospective cohort study of patients in South Africa.…”

Section: Introductionmentioning

confidence: 99%

“…The impact of HIV is also mixed with regard to worse patterns of anti‐TB drug resistance, including M. tuberculosis with resistance to at least isoniazid, rifampicin, any fluoroquinolone and any second‐line injectable drug [previous definition of extensively drug‐resistant TB (XDR‐TB)] 7–11 . Evidence on HIV disease indicators following DR‐TB treatment is scarce, as highlighted in a systematic review of the effects of DR‐TB treatment on HIV disease 12 …”

Section: Introductionmentioning

confidence: 99%

“… 7 , 8 , 9 , 10 , 11 Evidence on HIV disease indicators following DR‐TB treatment is scarce, as highlighted in a systematic review of the effects of DR‐TB treatment on HIV disease. 12 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

High mortality among patients hospitalized for drug‐resistant tuberculosis with acquired second‐line drug resistance and high HIV prevalence

et al. 2022

View full text Add to dashboard Cite

Objectives We compared mortality between HIV‐positive and HIV‐negative South African adults with drug‐resistant tuberculosis (DR‐TB) and high incidence of acquired second‐line drug resistance. Methods We performed a retrospective review of DR‐TB patients with serial second‐line TB drug susceptibility tests (2008–2015) who were hospitalized at a specialized TB hospital. We used Kaplan–Meier analysis and Cox models to examine associations with mortality. Results Of 245 patients, the median age was 33 years, 54% were male and 40% were HIV‐positive, 96% of whom had ever received antiretroviral therapy (ART). At initial drug resistance detection, 99% of patients had resistance to at least rifampicin and isoniazid, and 18% had second‐line drug resistance (fluoroquinolones and/or injectable drugs). At later testing, 88% of patients had acquired additional second‐line drug resistance. Patient‐initiated treatment interruptions (> 2 months) occurred in 47%. Mortality was 79%. Those with HIV had a shorter time to death ( p = 0.02; log‐rank): median survival time from DR‐TB treatment initiation was 2.44 years [95% confidence interval (CI): 2.09–3.15] versus 3.99 years (95% CI: 3.12–4.75) for HIV‐negative patients. HIV‐positive patients who received ART within 6 months before DR‐TB treatment had a higher mortality hazard than HIV‐negative patients [adjusted hazard ratio (aHR) ratio = 1.82, 95% CI: 1.21–2.74]. By contrast, HIV‐positive patients who did not receive ART within 6 months before DR‐TB treatment did not have a significantly higher mortality hazard than HIV‐negative patients (aHR = 1.09; 95% CI: 0.72–1.65), although those on ART had lower median CD4 counts than those not on ART (157 vs. 281 cells/μL, respectively; p = 0.02). Conclusions A very high incidence of acquired second‐line drug resistance and high overall mortality were observed, reinforcing the need to reduce the risk of acquired resistance and for more effective treatment.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

High mortality among patients hospitalized for drug‐resistant tuberculosis with acquired second‐line drug resistance and high HIV prevalence

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Living in a township has been associated with lack of viral suppression at the time of MDR-TB treatment initiation, and it is likely that the issues that could drive this association such as poverty, poor access to services, crowded conditions, and generational poverty would continue to have an impact during MDR-TB treatment. 28 Having a prior TB episode also decreased odds of HIV viral suppression. This association could be due to clinical factors such as the well-established association between a detectable HIV VL and TB reinfection.…”

Section: Discussionmentioning

confidence: 98%

“…3 Although the effects of living with HIV on MDR-TB outcomes have been investigated, HIV treatment outcomes among people cotreated for MDR-TB and HIV are relatively unexplored. 4 HIV viral load (VL) is widely considered the most important indicator of HIV treatment efficacy because of its sensitivity to detect changes in viral replication rapidly. Achieving viral suppression is the goal for all people with HIV (PWH) to prevent disease progression, ensure that PWH live without complications, and prevent new HIV infections.…”

Section: Introductionmentioning

confidence: 99%

Successful Multidrug-Resistant Tuberculosis Treatment Without HIV Viral Suppression: A Missed Opportunity

Geiger,

Patil,

Budhathoki

et al. 2023

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

Background Co-infection with multidrug-resistant tuberculosis (MDR-TB) and human immunodeficiency virus (HIV) is common, but few published studies examine how undergoing MDR-TB treatment impacts HIV disease indicators. Methods Using data from a nested, retrospective cohort of people with HIV (PWH) and successful MDR-TB treatment outcomes, we built multivariable regression models to explore correlates of HIV viral suppression at MDR-TB treatment completion. Results Among 532 PWH successfully treated for MDR-TB, mean age was 37.4 years (SD 10.2, IQR 30-43), 271 (50.9%) were male, 396 (74.4%) were virally suppressed at MDR-TB outcome, and 259 (48.7%) took bedaquiline. Older age (aOR 1.04, 95% CI 1.01-1.06) increased odds of viral suppression, while having a prior TB episode (aOR 0.45, 95% CI 0.31-0.64), having a detectable viral load at MDR-TB treatment initiation (aOR 0.17, 95% CI 0.09-0.30), living in a township (aOR 0.49, 95% CI 0.28-0.86), and being changed from efavirenz-based antiretroviral therapy (ART) to a protease inhibitor due to bedaquiline usage (aOR 0.19, 95% CI 0.04-0.81) or not having an ART change while on bedaquiline (aOR 0.29, 95% CI 0.11-0.75) lowered odds of viral suppression. Changing from efavirenz to nevirapine due to bedaquiline usage did not significantly affect odds of viral suppression (aOR 0.40, 95% CI 0.16-1.04). Conclusion Increased pill burden and adverse treatment effects did not significantly affect HIV viral suppression, while switching ART to a protease inhibitor to accommodate bedaquiline or not changing ART while taking bedaquiline did, suggesting that PWH and MDR-TB may benefit from additional support if they must switch ART.

show abstract

A Retroactive Study on Factors Influencing the Efficacy of Treatment for Tuberculosis Patients with HIV: based on the data from 2010 to 2020 in Shanghai, China

Dong,

Zhang,

et al. 2023

Preprint

View full text Add to dashboard Cite

At present, the factors influencing Tuberculosis (TB) treatment effectiveness in HIV/TB co-infected patients need to be supported by more substantial real-world evidence. A retrospective study is conducted to fill the vacancy. 461 TB patients with HIV are defined as 742 samples according to each TB detection period. 7788 valid treatment records corresponding to 17 drug compositions for TB and 150 clinical indicators with more than 100 records are used to conduct data mining with consensus clustering, Fisher’s exact test, stratified analysis, and three modeling approaches, including logistic regression, support vector machine, and random forest. We find that A CD4+T cell count of 42 cells per μL may serve as a sensitive classification standard for the immune level to assist in evaluating or predicting the efficacy of TB (P=0.007); Rifabutin and levofloxacin alone or in combination may be more effective than other first- and second-line anti-TB agents in combination (P=0.037); Samples with low immune levels (CD4≦42) may be more resistant to first-line TB drugs (P=0.049); Age (P=0.015), bicarbonate radical (P=0.007), high-density lipoprotein cholesterol (P=0.026), pre-treatment CD8+T cell count (P=0.015, age<60, male), neutrophil percentage (P=0.033, age<60), rifabutin (P=0.010, age<60), and cycloserine (P=0.027, age<60) may influence the TB treatment effectiveness; More evidence is needed to support the relationship between pre-treatment clinical indicators or drug regimens and TB treatment effectiveness (The best AUC is 0.560∼0.763); The percentage of lymphocytes (P=0.028) can be used as an effective TB therapeutic target. These perspectives supplement knowledge in relevant clinical aspects.

show abstract

The effects of MDR/RR-TB treatment on HIV disease: A systematic review of literature

Cited by 6 publications

References 26 publications

High mortality among patients hospitalized for drug‐resistant tuberculosis with acquired second‐line drug resistance and high HIV prevalence

High mortality among patients hospitalized for drug‐resistant tuberculosis with acquired second‐line drug resistance and high HIV prevalence

Successful Multidrug-Resistant Tuberculosis Treatment Without HIV Viral Suppression: A Missed Opportunity

A Retroactive Study on Factors Influencing the Efficacy of Treatment for Tuberculosis Patients with HIV: based on the data from 2010 to 2020 in Shanghai, China

Contact Info

Product

Resources

About