Eligibility for and outcome of treatment of latent tuberculosis infection in a cohort of HIV-infected people in Spain

BMC Infectious Diseases

Research Article

Mercedes Diez¹  Monica Trastoy²  Pompeyo Viciana²  Juan Miguel Santamaría³  Oscar Ferrero³  Miguel Camafort⁴  Joseba Portu⁵  Mikel Aldamiz⁵  Paloma Geijo⁶  Carmen Rosa⁶  Maria Elena Moreno⁷  Santiago Moreno⁷  Jose Antonio Iribarren⁸  Xabier Camino⁸  Javier Pinilla⁹  Pablo Labarga⁹  Federico Pulido^1,10  Asuncion Costa^1,10  Concepcion Cepeda^1,10  Mauricio Telenti^1,11  Luis Trapiella^1,11  Asuncion Diaz^1,12  Maria Jose Bleda^1,12 

[1] Secretaria del Plan Nacional sobre el sida, Ministerio de Sanidad y Política Social, Madrid, Spain;Servicio Enfermedades Infecciosas, Hospital Virgen del Rocío, Sevilla, Spain;Servicio Enfermedades Infecciosas, Hospital de Basurto, Bilbao, Spain;Servicio Medicina Interna, Hospital Mora d'Ebre, Instituto de Investigación Sanitaria "Pere Virgili", Universidad "Rovira i Virgili", Mora d'Ebre, Spain;Servicio Medicina Interna, Hospital Txagorritxu, Vitoria, Spain;Servicio Medicina Interna, Hospital Virgen de la Luz, Cuenca, Spain;Servicio de Enfermedades Infeccciosas, Hospital Ramón y Cajal, Madrid, Spain;Servicio de Enfermedades Infecciosas, Hospital Ntra Sra de Aranzazu, San Sebastián, Spain;Servicio de Medicina Interna, Hospital San Millán, Logroño, Spain;Unidad VIH, Hospital Doce de Octubre, Madrid, Spain;Unidad de Enfermedades Infecciosas, Hospital Universitario Central de Asturias, Oviedo, Spain;Unidad de Epidemiología del VIH/SIDA, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain;

关键词: Isoniazid;    Tuberculin Skin Testing;    Pyrazinamide;    Treatment Completion;    Latent Tuberculosis Infection;   

DOI  :  10.1186/1471-2334-10-267

 received in 2010-02-17, accepted in 2010-09-14,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundPrevious studies have demonstrated the efficacy of treatment for latent tuberculosis infection (TLTBI) in persons infected with the human immunodeficiency virus, but few studies have investigated the operational aspects of implementing TLTBI in the co-infected population.The study objectives were to describe eligibility for TLTBI as well as treatment prescription, initiation and completion in an HIV-infected Spanish cohort and to investigate factors associated with treatment completion.MethodsSubjects were prospectively identified between 2000 and 2003 at ten HIV hospital-based clinics in Spain. Data were obtained from clinical records. Associations were measured using the odds ratio (OR) and its 95% confidence interval (95% CI).ResultsA total of 1242 subjects were recruited and 846 (68.1%) were evaluated for TLTBI. Of these, 181 (21.4%) were eligible for TLTBI either because they were tuberculin skin test (TST) positive (121) or because their TST was negative/unknown but they were known contacts of a TB case or had impaired immunity (60). Of the patients eligible for TLTBI, 122 (67.4%) initiated TLTBI: 99 (81.1%) were treated with isoniazid for 6, 9 or 12 months; and 23 (18.9%) with short-course regimens including rifampin plus isoniazid and/or pyrazinamide. In total, 70 patients (57.4%) completed treatment, 39 (32.0%) defaulted, 7 (5.7%) interrupted treatment due to adverse effects, 2 developed TB, 2 died, and 2 moved away. Treatment completion was associated with having acquired HIV infection through heterosexual sex as compared to intravenous drug use (OR:4.6; 95% CI:1.4-14.7) and with having taken rifampin and pyrazinamide for 2 months as compared to isoniazid for 9 months (OR:8.3; 95% CI:2.7-24.9).ConclusionsA minority of HIV-infected patients eligible for TLTBI actually starts and completes a course of treatment. Obstacles to successful implementation of this intervention need to be addressed.

【 授权许可】

CC BY   
© Diaz et al; licensee BioMed Central Ltd. 2010