Comparison of intermittent ethambutol with rifampicin-based regimens in HIV-infected adults with PTB, Kampala

Alphonse Okwera, J. L. Johnson, H. Luzze, P. Nsubuga, H. Kayanja, D. L. Cohn, P. Nunn, J. J. Ellner, C. C. Whalen, R. D. Mugerwa

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The human immunodeficiency virus (HIV) is a key factor responsible for the high rates of tuberculosis (TB) in sub-Saharan Africa. Treatment of TB with rifampicin (R, RMP) containing short-course regimens is highly effective in HIV-infected adults. We conducted a study to compare the efficacy and safety of intermittent ethambutol (E, EMB) with two RMP-containing regimens to treat pulmonary TB in HIV-infected patients. SETTING: National Tuberculosis Treatment Centre, Mulago Hospital, Kampala, Uganda. DESIGN: This was a prospective cohort compared to two non-randomised control groups. The study group and the two control arms were treated with 2 months of isoniazid (H), RMP, pyrazinamide (Z) and EMB followed by 6 E3H3 for the study group and 4HR or 6HR for controls. RESULTS: Between April 1993 and March 2000, 136 patients were enrolled in the 2EHRZ/E3H3 arm, 147 in the 2EHRZ/4HR arm and 266 in the 2EHRZ/6HR arm. The relapse rate was 18.2 per 100 person-years observation (PYO) for the study regimen compared to 9.7/100 PYO (P = 0.0063) and 4.8/100 PYO (P = 0.0001) in patients treated with 2 EHRZ/4HR or 2EHRZ/6HR, respectively. CONCLUSION: The 2EHRZ/6E3H3 regimen is safe and effective but has a significant risk of relapse.

Original languageEnglish (US)
Pages (from-to)39-44
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Volume10
Issue number1
StatePublished - Jan 2006
Externally publishedYes

Keywords

  • Ethambutol
  • HIV/AIDS
  • Rifampicin
  • Treatment
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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    Okwera, A., Johnson, J. L., Luzze, H., Nsubuga, P., Kayanja, H., Cohn, D. L., Nunn, P., Ellner, J. J., Whalen, C. C., & Mugerwa, R. D. (2006). Comparison of intermittent ethambutol with rifampicin-based regimens in HIV-infected adults with PTB, Kampala. International Journal of Tuberculosis and Lung Disease, 10(1), 39-44.