Efficacy of an unsupervised 8-month rifampicin-containing regimen for the treatment of pulmonary tuberculosis in HIV-infected adults

J. L. Johnson, A. Okwera, P. Nsubuga, J. G. Nakibali, C. C. Whalen, D. Hom, M. D. Cave, Z. H. Yang, R. D. Mugerwa, J. J. Ellner

Research output: Contribution to journalArticle

Abstract

Setting: National Tuberculosis Treatment Centre, Mulago Hospital, Kampala, Uganda. Objective: To assess the efficacy of a daily, self-administered 8-month rifampicin-containing regimen for the treatment of pulmonary tuberculosis (TB) in human immunodeficiency virus (HIV) infected adults. Design: Treatment outcomes in patients with pulmonary TB treated with a single 8-month regimen and followed in a prospective epidemiological study. Results: Two hundred and sixty-five HIV-infected and 26 non-HIV-infected adults with initial episodes of pulmonary tuberculosis were treated with 2 months of daily isoniazid (INH), rifampicin (RMP), ethambutol and pyrazinamide followed by 6 months of daily INH + RMP. Median follow-up was 17.8 months. Ninety-five per cent of the HIV-infected and all of the non-HIV-infected patients who had sputum examined were sputum culture negative after 2 months of treatment. Twenty-two HIV-infected and no non-HIV-infected patients died during treatment. Relapse rates were 8.4% (5.9 per 100 person-years of observation [PYO], 95%CI 3.2-8.6) among HIV-infected patients and 4.5% (2.1/100 PYO, 95%CI 0-7.8) for non-HIV-infected patients. Adverse drug reactions occurred in 37% of the HIV-infected patients; most were minor and self-limiting. Conclusion: An 8-month RMP-containing regimen was well tolerated and effective in the treatment of HIV-infected adults with initial episodes of pulmonary TB. Relapse rates were similar to those reported with 6-month short-course regimens in HIV-infected individuals. Decisions about the duration of anti-tuberculosis treatment for HIV-infected adults must balance programme resources and the likelihood of poor compliance with longer regimens with the potential for a modest decrease in relapses with longer treatment.

Original languageEnglish (US)
Pages (from-to)1032-1040
Number of pages9
JournalInternational Journal of Tuberculosis and Lung Disease
Volume4
Issue number11
StatePublished - 2000
Externally publishedYes

Keywords

  • AIDS
  • HIV
  • Relapse
  • RFLP
  • Rifampicin
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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    Johnson, J. L., Okwera, A., Nsubuga, P., Nakibali, J. G., Whalen, C. C., Hom, D., Cave, M. D., Yang, Z. H., Mugerwa, R. D., & Ellner, J. J. (2000). Efficacy of an unsupervised 8-month rifampicin-containing regimen for the treatment of pulmonary tuberculosis in HIV-infected adults. International Journal of Tuberculosis and Lung Disease, 4(11), 1032-1040.