RESEARCH PAPER
Survival rate of multi-drug resistant tuberculosis among human immunodeficiency virus co-infected patients in Sanglah Hospital/Udayana University, Bali, Indonesia: a cohort retrospective study
 
More details
Hide details
1
Medical Faculty of Udayana University, Bali, Indonesia
 
2
Department of Infectious Diseases and Tropical Medicine, Sanglah Public General Hospital/Medical Faculty of Udayana University, Bali, Indonesia
 
 
Submission date: 2020-09-06
 
 
Final revision date: 2020-10-04
 
 
Acceptance date: 2020-10-05
 
 
Publication date: 2021-06-30
 
 
HIV & AIDS Review 2021;20(2):109-113
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Tuberculosis (TB) and human immunodeficiency virus (HIV) are corelated infectious diseases and their worldwide spread became a global health problem. Moreover, HIV patients with TB are able to develop multi-drug resistance tuberculosis (MDR-TB) and extensive drug-resistant TB (XDR-TB), which make treatments more challenging and affect survival rate. This study aimed to observe survival rate of HIV-positive patients with MDR-TB.

Material and methods:
This retrospective, analytical study was conducted in Sanglah Public Hospital from February till April 2018. Data was obtained using total sampling; 98 samples were collected from medical records, including 19 HIV-infected and 77 non-HIV patients, who fulfilled inclusion and exclusion criteria. Analysis was performed with univariate and bivariate survival analysis. Primary outcome was survival.

Results:
Median age was 40 (range, 12-65) years; in HIV group, it was 38 (range, 23-65) years and 40 (range, 12-63) years in non-HIV group. Gender ratio between male and female was nearly 1 : 1; association between HIV status with outcome was significant, but statistical (p < 0.0001) and cofounding variables were not. Mean of survival in HIV group was significantly shorter than in non-HIV group (2.6 ± 0.5 years vs. 5.1 ± 0.2 years), and 5-year survival rate was 52.1% vs. 81.9%, respectively. Mantel Cox was applied to compare log-rank test, with significant association between HIV status and survival (p = 0.001). Survival rate hazard ratio for MDR-TB in HIV group was 4.17 (range, 1.67-10.4).

Conclusions:
Decreasing outcome and survival rate among are considered factors associated with MDR-TB in HIV-positive patients than in non-HIV-infected individuals.

 
REFERENCES (26)
1.
WHO. WHO | Tuberculosis and HIV. WHO [Internet]. 2015.
 
2.
Available from: http://www.who.int/hiv/topics/... (Accessed: 21.08.2017).
 
3.
Kemenkes RI. Pedoman Nasional Pengendalian Tuberkulosis. Kementrian Kesehatan, Jakarta 2014.
 
4.
Kemenkes RI. InfoDATIN Tuberkulosis. 2016.
 
5.
World Health Organization. Tuberculosis [Internet]. 2017. Available from: http://www.who.int/mediacentre... (Accessed: 17.08.2017).
 
6.
World Health Organization (WHO). WHO | Drug-resistant tuberculosis. WHO [Internet]. 2018. Available from: http://www.who.int/tb/areas-of... (Accessed: 28.08.2018).
 
7.
Institute of Medicine. Addressing the Threat of Drug-Resistant Tuberculosis: a Realistic Assessment of the Challenge: Workshop Summary. National Academics Press, Washington 2009.
 
8.
Gurumurthy P, Ramachandran G, Kumar AKH, et al. Decreased Bioavailability of rifampin and other antituberculosis drugs in patients with advanced human immunodeficiency virus disease. Antimicrob Agents Chemother 2004; 48: 4473-4475.
 
9.
Wells CD, Cegielski JP, Nelson LJ, et al. HIV infection and multidrug-resistant tuberculosis – the perfect storm. J Infect Dis 2007; 196 Suppl 1: S86-107.
 
10.
Coker RJ. Review: multidrug-resistant tuberculosis: public health challenges. Trop Med Int Health 2004; 9: 25-40.
 
11.
Drobniewski F, Eltringham I, Graham C, Magee JG, Smith EG, Watt B. A national study of clinical and laboratory factors affecting the survival of patients with multiple drug resistant tuberculosis in the UK. Thorax 2002; 57: 810-816.
 
12.
Suchindran S, Brouwer ES, Van Rie A. Is HIV infection a risk factor for multi-drug resistant tuberculosis? A systematic review. PLoS One 2009; 4: e5561.
 
13.
Gandhi NR, Shah NS, Andrews JR, et al. HIV coinfection in multidrug- and extensively drug-resistant tuberculosis results in high early mortality. Am J Respir Crit Care Med 2010; 181: 80-86.
 
14.
Brust JCM, Gandhi NR, Carrara H, Osburn G, Padayatchi N. High treatment failure and default rates for patients with multidrug-.
 
15.
resistant tuberculosis in KwaZulu-Natal, South Africa, 2000-2003. Int J Tuberc Lung Dis 2010; 14: 413-419.
 
16.
Isaakidis P, Casas EC, Das M, Tseretopoulou X, Ntzani EE, Ford N. Treatment outcomes for HIV and MDR-TB co-infected adults and children: systematic review and meta-analysis. Int J Tuberc Lung Dis 2015; 19: 969-978.
 
17.
Gandhi NR, Andrews JR, Brust JCM, et al. Risk factors for mortality among MDR- and XDR-TB patients in a high HIV prevalence setting. Int J Tuberc Lung Dis 2012; 16: 90-97.
 
18.
Brust JCM, Shah NS, Mlisana K, et al. Improved survival and cure rates with concurrent treatment for multidrug-resistant tuberculosis-human immunodeficiency virus coinfection in South Africa. Clin Infect Dis 2018; 66: 1246-1253.
 
19.
O’Donnell MR, Padayatchi N, Kvasnovsky C, Werner L, Master I,.
 
20.
Horsburgh CRJ. Treatment outcomes for extensively drug-resistant tuberculosis and HIV co-infection. Emerg Infect Dis 2013; 19: 416-424.
 
21.
Dheda K, Shean K, Zumla A, et al. Early treatment outcomes and HIV status of patients with extensively drug-resistant tuberculosis in South Africa: a retrospective cohort study. Lancet 2010; 375: 1798-1807.
 
22.
Bloss E, Kuksa L, Holtz TH, et al. Adverse events related to multidrug-resistant tuberculosis treatment, Latvia, 2000-2004. Int J Tuberc Lung Dis 2010; 14: 275-281.
 
23.
Poorolajal J, Hooshmand E, Mahjub H, Esmailnasab N, Jenabi E. Survival rate of AIDS disease and mortality in HIV-infected patients: a meta-analysis. Public Health 2016; 139: 3-12.
 
24.
Manosuthi W, Chottanapand S, Thongyen S. Survival rate and risk factors of mortality among HIV/tuberculosis-coinfected patients with and without antiretroviral therapy. Clin Sci 2006; 43: 42-46.
 
25.
Manda SO, Masenyetse LJ, Lancaster JL, van der Walt ML. Risk of death among HIV co-infected multidrug resistant tuberculosis patients, compared to mortality in the general population of South Africa. J AIDS Clin Res 2013; Suppl 3: 7.
 
26.
Shin SS, Modongo C, Boyd R, et al. High treatment success rates among HIV-infected multidrug-resistant tuberculosis patients after expansion of antiretroviral therapy in Botswana, 2006-2013. J Acquir Immune Defic Syndr 2017; 74: 65-71.
 
eISSN:1732-2707
ISSN:1730-1270
Journals System - logo
Scroll to top