Risk factors for relapse in human immunodeficiency virus type 1 infected adults with pulmonary tuberculosis
SETTING: A study conducted by the Uganda-Case Western Reserve University Research Collaboration in Kampala, Uganda, a country with high incidence rates of tuberculosis (TB) and human immunodeficiency virus type 1 (HIV-1) infection.OBJECTIVE: To assess clinical, microbiologic and radiographic factors...
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| Veröffentlicht in: | The international journal of tuberculosis and lung disease 1997-10, Vol.1 (5), p.446-453 |
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| creator | Johnson, J L Okwera, A Vjecha, M J Byekwaso, F Nakibali, J Nyole, S Milberg, J Aisu, T Whalen, C C Mugerwa, R D Ellner, J J |
| description | SETTING: A study conducted by the Uganda-Case Western Reserve University Research Collaboration in Kampala, Uganda, a country with high incidence rates of tuberculosis (TB) and human immunodeficiency virus type 1 (HIV-1) infection.OBJECTIVE: To assess clinical, microbiologic and
radiographic factors associated with risk for relapse in HIV-infected adults treated for initial episodes of pulmonary TB.DESIGN: Nested case-control study within a randomized prospective clinical trial comparing the safety and efficacy of thiacetazone- and rifampicin-containing regimens
for TB treatment in HIV-infected adults.RESULTS: The analysis was based on 119 patients who completed therapy. Median follow-up for all subjects was 22.3 months. Ten patients relapsed a median of 12.7 months after the end of therapy; seven of these were initially treated with the thiacetazone
(T)-containing regimen. Each relapse case was matched to four controls by length of follow-up after initial TB treatment. In a univariate analysis risk for relapse was associated with treatment with the T-containing regimen (OR = 4.2, P = 0.08), age ≥30 yrs (OR =
2.9, P = 0.16), and irregular compliance (OR = 3.6, P = 0.1). Baseline anergy on Mantoux tuberculin skin testing, cavitary disease, radiographic extent of disease and sputum bacillary burden, two month culture negativity, and residual cavitary disease at
the end of treatment did not differ between relapses and controls.CONCLUSION: Older HIV-1 infected patients, those with poor treatment compliance, and those being treated with T-containing regimens, may be at increased risk for relapse after TB treatment and require closer post-treatment
surveillance. Risk for relapse in HIV-infected adults with pulmonary TB after treatment with a nine month rifampicin-containing regimen was low (3.1 per 100 person-years observation) compared with those treated with a thiacetazone-containing regimen (10.1 per 100 person-years observation). |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmed_primary_9441100</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ingid>iuatld/ijtld/1997/00000001/00000005/art00011</ingid><sourcerecordid>79464090</sourcerecordid><originalsourceid>FETCH-LOGICAL-i267t-dafc8a8a8a7f51a889e4ca41a46899fbd9c8d52903ba4c923c6e945ec265fe8d3</originalsourceid><addsrcrecordid>eNo1UNtKAzEQzYNStfoJQp58W0h2s5c8Sr1CQRB9DtlkYtNms2suSv_eLa0zMDPMOWc4zBm6pKRsi6ql_AJdxbglpKSUtgu04IxRSsgl2r3buMNGqjSGiM0YcAAnpwjYerzJg_TYDkP2owZjlQWv9vjHhhxx2k-A6UwzoBJoLHV2KeJfmzZ4ym4YvQx7nHIPQWU3Rhuv0bmRLsLNqS_R59Pjx-qlWL89v67u14UtmzYVWhrVyUO2pqay6zgwJRmVrOk4N73mqtN1yUnVS6Z4WakGOKtBlU1toNPVEt0d705h_M4QkxhsVOCc9DDmKFrOGkZm_RLdnoi5H0CLKdhhNi1O35nxhyNu_Rf4JMV2zMHP1oXNMjkt7PZQKeetIMeg_0MtZEiHBa3-AFq1eJQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>79464090</pqid></control><display><type>article</type><title>Risk factors for relapse in human immunodeficiency virus type 1 infected adults with pulmonary tuberculosis</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Johnson, J L ; Okwera, A ; Vjecha, M J ; Byekwaso, F ; Nakibali, J ; Nyole, S ; Milberg, J ; Aisu, T ; Whalen, C C ; Mugerwa, R D ; Ellner, J J</creator><creatorcontrib>Johnson, J L ; Okwera, A ; Vjecha, M J ; Byekwaso, F ; Nakibali, J ; Nyole, S ; Milberg, J ; Aisu, T ; Whalen, C C ; Mugerwa, R D ; Ellner, J J</creatorcontrib><description>SETTING: A study conducted by the Uganda-Case Western Reserve University Research Collaboration in Kampala, Uganda, a country with high incidence rates of tuberculosis (TB) and human immunodeficiency virus type 1 (HIV-1) infection.OBJECTIVE: To assess clinical, microbiologic and
radiographic factors associated with risk for relapse in HIV-infected adults treated for initial episodes of pulmonary TB.DESIGN: Nested case-control study within a randomized prospective clinical trial comparing the safety and efficacy of thiacetazone- and rifampicin-containing regimens
for TB treatment in HIV-infected adults.RESULTS: The analysis was based on 119 patients who completed therapy. Median follow-up for all subjects was 22.3 months. Ten patients relapsed a median of 12.7 months after the end of therapy; seven of these were initially treated with the thiacetazone
(T)-containing regimen. Each relapse case was matched to four controls by length of follow-up after initial TB treatment. In a univariate analysis risk for relapse was associated with treatment with the T-containing regimen (OR = 4.2, P = 0.08), age ≥30 yrs (OR =
2.9, P = 0.16), and irregular compliance (OR = 3.6, P = 0.1). Baseline anergy on Mantoux tuberculin skin testing, cavitary disease, radiographic extent of disease and sputum bacillary burden, two month culture negativity, and residual cavitary disease at
the end of treatment did not differ between relapses and controls.CONCLUSION: Older HIV-1 infected patients, those with poor treatment compliance, and those being treated with T-containing regimens, may be at increased risk for relapse after TB treatment and require closer post-treatment
surveillance. Risk for relapse in HIV-infected adults with pulmonary TB after treatment with a nine month rifampicin-containing regimen was low (3.1 per 100 person-years observation) compared with those treated with a thiacetazone-containing regimen (10.1 per 100 person-years observation).</description><identifier>ISSN: 1027-3719</identifier><identifier>PMID: 9441100</identifier><language>eng</language><publisher>Paris, France: IUATLD</publisher><subject>Adolescent ; Adult ; AIDS-Related Opportunistic Infections - diagnosis ; AIDS-Related Opportunistic Infections - drug therapy ; AIDS-Related Opportunistic Infections - mortality ; AIDS/HIV ; Antitubercular Agents - therapeutic use ; Case-Control Studies ; Developing Countries ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; HIV ; HIV-1 ; Humans ; Logistic Models ; Lung - diagnostic imaging ; Male ; Middle Aged ; Patient Compliance ; Prospective Studies ; Radiography ; Recurrence ; Relapse ; rifampicin ; Rifampin - therapeutic use ; Risk Factors ; Sputum - microbiology ; Survival Rate ; Thiacetazone ; Thioacetazone - therapeutic use ; Tuberculosis ; Tuberculosis, Pulmonary - diagnosis ; Tuberculosis, Pulmonary - drug therapy ; Tuberculosis, Pulmonary - mortality ; Uganda - epidemiology</subject><ispartof>The international journal of tuberculosis and lung disease, 1997-10, Vol.1 (5), p.446-453</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9441100$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Johnson, J L</creatorcontrib><creatorcontrib>Okwera, A</creatorcontrib><creatorcontrib>Vjecha, M J</creatorcontrib><creatorcontrib>Byekwaso, F</creatorcontrib><creatorcontrib>Nakibali, J</creatorcontrib><creatorcontrib>Nyole, S</creatorcontrib><creatorcontrib>Milberg, J</creatorcontrib><creatorcontrib>Aisu, T</creatorcontrib><creatorcontrib>Whalen, C C</creatorcontrib><creatorcontrib>Mugerwa, R D</creatorcontrib><creatorcontrib>Ellner, J J</creatorcontrib><title>Risk factors for relapse in human immunodeficiency virus type 1 infected adults with pulmonary tuberculosis</title><title>The international journal of tuberculosis and lung disease</title><addtitle>Int J Tuberc Lung Dis</addtitle><description>SETTING: A study conducted by the Uganda-Case Western Reserve University Research Collaboration in Kampala, Uganda, a country with high incidence rates of tuberculosis (TB) and human immunodeficiency virus type 1 (HIV-1) infection.OBJECTIVE: To assess clinical, microbiologic and
radiographic factors associated with risk for relapse in HIV-infected adults treated for initial episodes of pulmonary TB.DESIGN: Nested case-control study within a randomized prospective clinical trial comparing the safety and efficacy of thiacetazone- and rifampicin-containing regimens
for TB treatment in HIV-infected adults.RESULTS: The analysis was based on 119 patients who completed therapy. Median follow-up for all subjects was 22.3 months. Ten patients relapsed a median of 12.7 months after the end of therapy; seven of these were initially treated with the thiacetazone
(T)-containing regimen. Each relapse case was matched to four controls by length of follow-up after initial TB treatment. In a univariate analysis risk for relapse was associated with treatment with the T-containing regimen (OR = 4.2, P = 0.08), age ≥30 yrs (OR =
2.9, P = 0.16), and irregular compliance (OR = 3.6, P = 0.1). Baseline anergy on Mantoux tuberculin skin testing, cavitary disease, radiographic extent of disease and sputum bacillary burden, two month culture negativity, and residual cavitary disease at
the end of treatment did not differ between relapses and controls.CONCLUSION: Older HIV-1 infected patients, those with poor treatment compliance, and those being treated with T-containing regimens, may be at increased risk for relapse after TB treatment and require closer post-treatment
surveillance. Risk for relapse in HIV-infected adults with pulmonary TB after treatment with a nine month rifampicin-containing regimen was low (3.1 per 100 person-years observation) compared with those treated with a thiacetazone-containing regimen (10.1 per 100 person-years observation).</description><subject>Adolescent</subject><subject>Adult</subject><subject>AIDS-Related Opportunistic Infections - diagnosis</subject><subject>AIDS-Related Opportunistic Infections - drug therapy</subject><subject>AIDS-Related Opportunistic Infections - mortality</subject><subject>AIDS/HIV</subject><subject>Antitubercular Agents - therapeutic use</subject><subject>Case-Control Studies</subject><subject>Developing Countries</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>HIV</subject><subject>HIV-1</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Lung - diagnostic imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patient Compliance</subject><subject>Prospective Studies</subject><subject>Radiography</subject><subject>Recurrence</subject><subject>Relapse</subject><subject>rifampicin</subject><subject>Rifampin - therapeutic use</subject><subject>Risk Factors</subject><subject>Sputum - microbiology</subject><subject>Survival Rate</subject><subject>Thiacetazone</subject><subject>Thioacetazone - therapeutic use</subject><subject>Tuberculosis</subject><subject>Tuberculosis, Pulmonary - diagnosis</subject><subject>Tuberculosis, Pulmonary - drug therapy</subject><subject>Tuberculosis, Pulmonary - mortality</subject><subject>Uganda - epidemiology</subject><issn>1027-3719</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1UNtKAzEQzYNStfoJQp58W0h2s5c8Sr1CQRB9DtlkYtNms2suSv_eLa0zMDPMOWc4zBm6pKRsi6ql_AJdxbglpKSUtgu04IxRSsgl2r3buMNGqjSGiM0YcAAnpwjYerzJg_TYDkP2owZjlQWv9vjHhhxx2k-A6UwzoBJoLHV2KeJfmzZ4ym4YvQx7nHIPQWU3Rhuv0bmRLsLNqS_R59Pjx-qlWL89v67u14UtmzYVWhrVyUO2pqay6zgwJRmVrOk4N73mqtN1yUnVS6Z4WakGOKtBlU1toNPVEt0d705h_M4QkxhsVOCc9DDmKFrOGkZm_RLdnoi5H0CLKdhhNi1O35nxhyNu_Rf4JMV2zMHP1oXNMjkt7PZQKeetIMeg_0MtZEiHBa3-AFq1eJQ</recordid><startdate>19971001</startdate><enddate>19971001</enddate><creator>Johnson, J L</creator><creator>Okwera, A</creator><creator>Vjecha, M J</creator><creator>Byekwaso, F</creator><creator>Nakibali, J</creator><creator>Nyole, S</creator><creator>Milberg, J</creator><creator>Aisu, T</creator><creator>Whalen, C C</creator><creator>Mugerwa, R D</creator><creator>Ellner, J J</creator><general>IUATLD</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>19971001</creationdate><title>Risk factors for relapse in human immunodeficiency virus type 1 infected adults with pulmonary tuberculosis</title><author>Johnson, J L ; Okwera, A ; Vjecha, M J ; Byekwaso, F ; Nakibali, J ; Nyole, S ; Milberg, J ; Aisu, T ; Whalen, C C ; Mugerwa, R D ; Ellner, J J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-i267t-dafc8a8a8a7f51a889e4ca41a46899fbd9c8d52903ba4c923c6e945ec265fe8d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>AIDS-Related Opportunistic Infections - diagnosis</topic><topic>AIDS-Related Opportunistic Infections - drug therapy</topic><topic>AIDS-Related Opportunistic Infections - mortality</topic><topic>AIDS/HIV</topic><topic>Antitubercular Agents - therapeutic use</topic><topic>Case-Control Studies</topic><topic>Developing Countries</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>HIV</topic><topic>HIV-1</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Lung - diagnostic imaging</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patient Compliance</topic><topic>Prospective Studies</topic><topic>Radiography</topic><topic>Recurrence</topic><topic>Relapse</topic><topic>rifampicin</topic><topic>Rifampin - therapeutic use</topic><topic>Risk Factors</topic><topic>Sputum - microbiology</topic><topic>Survival Rate</topic><topic>Thiacetazone</topic><topic>Thioacetazone - therapeutic use</topic><topic>Tuberculosis</topic><topic>Tuberculosis, Pulmonary - diagnosis</topic><topic>Tuberculosis, Pulmonary - drug therapy</topic><topic>Tuberculosis, Pulmonary - mortality</topic><topic>Uganda - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Johnson, J L</creatorcontrib><creatorcontrib>Okwera, A</creatorcontrib><creatorcontrib>Vjecha, M J</creatorcontrib><creatorcontrib>Byekwaso, F</creatorcontrib><creatorcontrib>Nakibali, J</creatorcontrib><creatorcontrib>Nyole, S</creatorcontrib><creatorcontrib>Milberg, J</creatorcontrib><creatorcontrib>Aisu, T</creatorcontrib><creatorcontrib>Whalen, C C</creatorcontrib><creatorcontrib>Mugerwa, R D</creatorcontrib><creatorcontrib>Ellner, J J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>The international journal of tuberculosis and lung disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Johnson, J L</au><au>Okwera, A</au><au>Vjecha, M J</au><au>Byekwaso, F</au><au>Nakibali, J</au><au>Nyole, S</au><au>Milberg, J</au><au>Aisu, T</au><au>Whalen, C C</au><au>Mugerwa, R D</au><au>Ellner, J J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for relapse in human immunodeficiency virus type 1 infected adults with pulmonary tuberculosis</atitle><jtitle>The international journal of tuberculosis and lung disease</jtitle><addtitle>Int J Tuberc Lung Dis</addtitle><date>1997-10-01</date><risdate>1997</risdate><volume>1</volume><issue>5</issue><spage>446</spage><epage>453</epage><pages>446-453</pages><issn>1027-3719</issn><abstract>SETTING: A study conducted by the Uganda-Case Western Reserve University Research Collaboration in Kampala, Uganda, a country with high incidence rates of tuberculosis (TB) and human immunodeficiency virus type 1 (HIV-1) infection.OBJECTIVE: To assess clinical, microbiologic and
radiographic factors associated with risk for relapse in HIV-infected adults treated for initial episodes of pulmonary TB.DESIGN: Nested case-control study within a randomized prospective clinical trial comparing the safety and efficacy of thiacetazone- and rifampicin-containing regimens
for TB treatment in HIV-infected adults.RESULTS: The analysis was based on 119 patients who completed therapy. Median follow-up for all subjects was 22.3 months. Ten patients relapsed a median of 12.7 months after the end of therapy; seven of these were initially treated with the thiacetazone
(T)-containing regimen. Each relapse case was matched to four controls by length of follow-up after initial TB treatment. In a univariate analysis risk for relapse was associated with treatment with the T-containing regimen (OR = 4.2, P = 0.08), age ≥30 yrs (OR =
2.9, P = 0.16), and irregular compliance (OR = 3.6, P = 0.1). Baseline anergy on Mantoux tuberculin skin testing, cavitary disease, radiographic extent of disease and sputum bacillary burden, two month culture negativity, and residual cavitary disease at
the end of treatment did not differ between relapses and controls.CONCLUSION: Older HIV-1 infected patients, those with poor treatment compliance, and those being treated with T-containing regimens, may be at increased risk for relapse after TB treatment and require closer post-treatment
surveillance. Risk for relapse in HIV-infected adults with pulmonary TB after treatment with a nine month rifampicin-containing regimen was low (3.1 per 100 person-years observation) compared with those treated with a thiacetazone-containing regimen (10.1 per 100 person-years observation).</abstract><cop>Paris, France</cop><pub>IUATLD</pub><pmid>9441100</pmid><tpages>8</tpages></addata></record> |
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| subjects | Adolescent Adult AIDS-Related Opportunistic Infections - diagnosis AIDS-Related Opportunistic Infections - drug therapy AIDS-Related Opportunistic Infections - mortality AIDS/HIV Antitubercular Agents - therapeutic use Case-Control Studies Developing Countries Drug Therapy, Combination Female Follow-Up Studies HIV HIV-1 Humans Logistic Models Lung - diagnostic imaging Male Middle Aged Patient Compliance Prospective Studies Radiography Recurrence Relapse rifampicin Rifampin - therapeutic use Risk Factors Sputum - microbiology Survival Rate Thiacetazone Thioacetazone - therapeutic use Tuberculosis Tuberculosis, Pulmonary - diagnosis Tuberculosis, Pulmonary - drug therapy Tuberculosis, Pulmonary - mortality Uganda - epidemiology |
| title | Risk factors for relapse in human immunodeficiency virus type 1 infected adults with pulmonary tuberculosis |
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