Comparison of intermittent ethambutol with rifampicin-based regimens in HIV-infected adults with PTB, Kampala.
BACKGROUND
The human immunodeficiency virus (HIV) is a key factor responsible for the high rates of tuberculosis (TB) in sub-Saharan Africa. Treatment of TB with rifampicin (R, RMP) containing short-course regimens is highly effective in HIV-infected adults. We conducted a study to compare the efficacy and safety of intermittent ethambutol (E, EMB) with two RMP-containing regimens to treat pulmonary TB in HIV-infected patients.


METHODS
National Tuberculosis Treatment Centre, Mulago Hospital, Kampala, Uganda.


METHODS
This was a prospective cohort compared to two non-randomised control groups. The study group and the two control arms were treated with 2 months of isoniazid (H), RMP, pyrazinamide (Z) and EMB followed by 6 E3H3 for the study group and 4HR or 6HR for controls.


RESULTS
Between April 1993 and March 2000, 136 patients were enrolled in the 2EHRZ/E3H3 arm, 147 in the 2EHRZ/4HR arm and 266 in the 2EHRZ/6HR arm. The relapse rate was 18.2 per 100 person-years observation (PYO) for the study regimen compared to 9.7/100 PYO (P = 0.0063) and 4.8/100 PYO (P = 0.0001) in patients treated with 2 EHRZ/4HR or 2EHRZ/6HR, respectively.


CONCLUSIONS
The 2EHRZ/6E3H3 regimen is safe and effective but has a significant risk of relapse.
Okwera
A
A
National Tuberculosis and Leprosy Programme, Kampala, Uganda-Case Western Reserve University Research Collaboration, Kampala, Uganda. a_okwera@mucwru.or.ug
Johnson
J L
JL
Luzze
H
H
Nsubuga
P
P
Kayanja
H
H
Cohn
D L
DL
Nunn
P
P
Ellner
J J
JJ
Whalen
C C
CC
Mugerwa
R D
RD
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence; D012293:Rifampin / Q000008:administration & dosage*; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*; D014454:Uganda
D000995:Antitubercular Agents; D004977:Ethambutol; D012293:Rifampin