June 14, 2010
Reports from South Africa's KwaZulu-Natal province suggest that almost all extensively drug-resistant TB (XDR TB) patients were HIV-positive, with a fatal result. Given the scarcity of data on XDR TB in settings with high HIV prevalence, the current retrospective cohort study examined the associations of HIV and XDR-TB to formulate recommendations for control programs.
The authors investigated case records of XDR TB patients with culture-proven diagnoses between August 2002 and February 2008 at four provincial treatment facilities. The study used Cox proportional hazards regression models to evaluate risk factors of mortality and culture conversion.
Of 227 patients over age 16, 195 were analyzed. Before any treatment was initiated, 21 died. Of 174 patients who began treatment (82 HIV-positive), 62 (36 percent) died during follow-up. However, the number of deaths was not significantly different between HIV-positive or -negative patients. Among those with HIV, 34 of 82 (41 percent) died, compared with 28 of 92 (30 percent) among patients without HIV (p=0.13).
05.22.2010; Vol. 375; No. 9728: P. 1798-1807; Keertan Dheda, PhD; and others
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