Relapse in persons treated for drug-susceptible tuberculosis in a population with high coinfection with human immunodeficiency virus in New York City.
The optimal duration of tuberculosis treatment for persons infected with human immunodeficiency virus (HIV) has been debated. A cohort of 4571 culture-positive drug-susceptible patients who received > or =24 weeks of standard 4-drug tuberculosis treatment were assessed to determine the incidence of tuberculosis relapse. Tuberculosis "recurrence" was defined as having a positive culture < 30 days after the last treatment date and "relapse" as having a positive culture > or =30 days after the last treatment. Patients infected with HIV were more likely than those who were uninfected to have recurrence or relapse (2.0 vs. 0.4 per 100 person-years, P< .001). Patients infected with HIV who received < or =36 weeks of treatment were more likely than those who received > 36 weeks to have a recurrence (7.9% vs. 1.4%, P< .001). Clinicians should be aware of the possibility of recurrence of tuberculosis 6-9 months after the start of treatment. Sputum evaluation to ensure cure or assessment 3 months after completion of treatment should be performed among persons infected with HIV who receive the shorter regimen.
Driver
C R
CR
Tuberculosis Control Program, New York City Department of Health, New York, NY, USA. cdriver@health.nyc.gov
Munsiff
S S
SS
Li
J
J
Kundamal
N
N
Osahan
S S
SS
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015331:Cohort Studies; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification; D009519:New York City / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*
D000995:Antitubercular Agents