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

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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.