Rifampicin resistance and mortality in patients hospitalised with HIV-associated tuberculosis

Southern African Journal of HIV Medicine

Field Value
Title Rifampicin resistance and mortality in patients hospitalised with HIV-associated tuberculosis
Creator Spies, Ruan Schutz, Charlotte Ward, Amy Balfour, Avuyonke Shey, Muki Nicol, Mark Burton, Rosie Sossen, Bianca Wilkinson, Robert Barr, David Meintjes, Graeme
Subject Medicine, internal medicine; infectious diseases HIV-associated tuberculosis; rifampicin-resistant tuberculosis; drug-resistant tuberculosis; multi-drug resistant TB; TB; Khayelitsha Hospital
Description Background: Patients with HIV and drug-resistant tuberculosis (TB) are at high risk of death.Objectives: We investigated the association between rifampicin-resistant TB (RR-TB) and mortality in a cohort of patients who were admitted to hospital at the time of TB diagnosis.Method: Adults hospitalised at Khayelitsha Hospital and diagnosed with HIV-associated TB during admission, were enrolled between 2013 and 2016. Clinical, biochemical and microbiological data were prospectively collected and participants were followed up for 12 weeks.Results: Participants with microbiologically confirmed TB (n = 482) were enrolled a median of two days (interquartile range [IQR]: 1–3 days) following admission. Fifty-three participants (11.0%) had RR-TB. Participants with rifampicin-susceptible TB (RS-TB) received appropriate treatment a median of one day (IQR: 1–2 days) following enrolment compared to three days (IQR: 1–9 days) in participants with RR-TB. Eight participants with RS-TB (1.9%) and six participants with RR-TB (11.3%) died prior to the initiation of appropriate treatment. Mortality at 12 weeks was 87/429 (20.3%) in the RS-TB group and 21/53 (39.6%) in the RR-TB group. RR-TB was a significant predictor of 12-week mortality (hazard ratio: 1.88; 95% confidence interval: 1.07–3.29; P = 0.03).Conclusion: Mortality at 12 weeks in participants with RR-TB was high compared to participants with RS-TB. Delays in the initiation of appropriate treatment and poorer regimen efficacy are proposed as contributors to higher mortality in hospitalised patients with HIV and RR-TB.
Publisher AOSIS
Date 2022-09-27
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Cohort
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajhivmed.v23i1.1396
Source Southern African Journal of HIV Medicine; Vol 23, No 1 (2022); 8 pages 2078-6751 1608-9693
Language eng
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https://sajhivmed.org.za/index.php/hivmed/article/view/1396/2859 https://sajhivmed.org.za/index.php/hivmed/article/view/1396/2860 https://sajhivmed.org.za/index.php/hivmed/article/view/1396/2861 https://sajhivmed.org.za/index.php/hivmed/article/view/1396/2862
Coverage South Africa; Western Cape; Cape Town — Hospitalised patient with HIV-associated tuberculosis
Rights Copyright (c) 2022 Ruan Spies, Charlotte Schutz, Amy Ward, Avuyonke Balfour, Muki Shey, Mark Nicol, Rosie Burton, Bianca Sossen, Robert Wilkinson, David Barr, Graeme Meintjes https://creativecommons.org/licenses/by/4.0