Six-month supervised intermittent tuberculosis therapy in Haitian patients with and without HIV infection

Richard E. Chaisson, H. Camil Clermont, Elizabeth A. Holt, Mireille Cantave, Michael P. Johnson, Joan Atkinson, Homer Davis, Reginald Boulos, Thomas C. Quinn, Neal A. Halsey, Julio Desormeaux, Henri Joseph, Josianne Buteau, Franz LaMothe, Robert Elie, Patricia Charache, Salman Siddiqi, Abigail Eaton, Audrey Clements

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Abstract

We enrolled 427 consecutive patients with tuberculosis diagnosed in Cite Soleil, Haiti in a trial of short-course intermittent therapy. All patients received supervised therapy with isoniazid, rifampin, pyrazinamide, and ethambutol thrice weekly for 8 wk, followed by isoniazid and rifampin thrice weekly for 18 wk. At entry, the 177 human immunodeficiency virus (HIV)- infected patients (42%) were found significantly more likely to have extrapulmonary tuberculosis and negative tuberculin skin tests (p < 0.05). Treatment was well tolerated by both groups of patients, and adherence to the treatment regimen was over 90%. Among patients with pulmonary or intrathoracic tuberculosis, 9% of HIV-seropositive and 1% of HIV-seronegative patients died during therapy (p < 0.001), whereas 81% and 87%, respectively, of those in the two groups were cured. Relapses occurred in 5.4% of HIV- seropositive and 2.8% of HIV-seronegative patients who completed treatment (p = 0.36). Survival after tuberculosis was poorer in HIV-seropositive patients, whose probability of dying was 33% at 18 mo after diagnosis as compared with 3% for HIV-seronegative patients (p < 0.001). HIV-seropositive patients who died had significantly lower median CD4 lymphocyte counts than did HIV- seropositive patients who survived (p < 0.001). Treatment of tuberculosis with short-course, thrice-weekly, supervised therapy in the setting of a developing country is highly efficacious in both HIV-seropositive and - seronegative patients.

Original languageEnglish (US)
Pages (from-to)1034-1038
Number of pages5
JournalAmerican journal of respiratory and critical care medicine
Volume154
Issue number4 I
DOIs
StatePublished - Jan 1 1996

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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    Chaisson, R. E., Clermont, H. C., Holt, E. A., Cantave, M., Johnson, M. P., Atkinson, J., Davis, H., Boulos, R., Quinn, T. C., Halsey, N. A., Desormeaux, J., Joseph, H., Buteau, J., LaMothe, F., Elie, R., Charache, P., Siddiqi, S., Eaton, A., & Clements, A. (1996). Six-month supervised intermittent tuberculosis therapy in Haitian patients with and without HIV infection. American journal of respiratory and critical care medicine, 154(4 I), 1034-1038. https://doi.org/10.1164/ajrccm.154.4.8887603