Tuberculosis mortality, drug resistance, and infectiousness in patients with and without HIV infection in Peru

Vivian Kawai, Giselle Soto, Robert H. Gilman, Christian T. Bautista, Luz Caviedes, Luz Huaroto, Eduardo Ticona, Jaime Ortiz, Marco Tovar, Victor Chavez, Richard Rodriguez, A. Roderick Escombe, Carlton A. Evans

Research output: Contribution to journalArticle

Abstract

The effects of HIV co-infection and multi-drug resistant tuberculosis (MDRTB) on tuberculosis prognosis are poorly defined. Therefore, we studied infectiousness and mortality of 287 tuberculosis patients treated with standard, directly observed, short-course therapy in the Peruvian community. During 6-17 months of treatment, 49 (18%) of patients died, of whom 48 (98%) had AIDS and 28 (57%) had MDRTB; 17/31 (55%) of MDRTB-patients with AIDS died within 2 months of diagnosis, before traditional susceptibility testing would have identified their MDRTB. Most non-MDRTB became smear- and culture-negative within 6 weeks of therapy, whereas most MDRTB remained sputum-culture-positive until death or treatment completion. HIV-negative patients with non-MDRTB had good outcomes. However, MDRTB was associated with prolonged infectiousness and HIV co-infection with early mortality, indicating a need for greater access to anti-retroviral therapy. Furthermore, early and rapid tuberculosis drug-susceptibility testing and infection control are required so that MDRTB can be appropriately treated early enough to reduce mortality and transmission.

Original languageEnglish (US)
Pages (from-to)1027-1033
Number of pages7
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume75
Issue number6
DOIs
StatePublished - Dec 2006

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases

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    Kawai, V., Soto, G., Gilman, R. H., Bautista, C. T., Caviedes, L., Huaroto, L., Ticona, E., Ortiz, J., Tovar, M., Chavez, V., Rodriguez, R., Escombe, A. R., & Evans, C. A. (2006). Tuberculosis mortality, drug resistance, and infectiousness in patients with and without HIV infection in Peru. American Journal of Tropical Medicine and Hygiene, 75(6), 1027-1033. https://doi.org/10.4269/ajtmh.2006.75.1027