title: Sputum conversion at the end of intensive phase of Category-1 regimen in the treatment of pulmonary tuberculosis patients with diabetes mellitus or HIV infection: An analysis of risk factors.
abstract: OBJECTIVE
  New smear-positive pulmonary tuberculosis (PTB) patients in the Revised National Tuberculosis Control Programme (RNTCP) are treated with a 6-month short-course chemotherapy (SCC) regimen irrespective of co-morbid conditions. We undertook this retrospective analysis to compare sputum conversion rates (smear, culture) at the end of intensive phase (IP) of Category-1 regimen among patients admitted to concurrent controlled clinical trials: pulmonary tuberculosis alone (PTB) or with type 2 diabetes mellitus (DM-TB) or HIV infection (HIV-TB), and to identify the risk factors influencing sputum conversion.
  
  
  METHODS
  In this retrospective analysis sputum conversion rates at the end of intensive phase (IP) in three concurrent studies undertaken among PTB, DM-TB and HIV-TB patients, during 1998 - 2002 at the Tuberculosis Research Centre (TRC), Chennai, were compared. Sputum smears were examined by fluorescent microscopy. HIV infected patients did not receive anti-retroviral treatment (ART). Patients with DM were treated with oral hypoglycaemic drugs or insulin (sc).
  
  
  RESULTS
  The study population included 98, 92 and 88 patients in the PTB, DM-TB and HIV-TB studies. At the end of IP the smear conversion (58, 61, and 62%) and culture conversion (86, 88 and 92%) rates were similar in the three groups respectively. The variables associated with lack of sputum smear or culture conversion were age >45 yr, higher pre-treatment smear and culture grading, and extent of the radiographic involvement.
  
  
  CONCLUSIONS
  Our findings confirm that the current policy of the control programme to treat all pulmonary TB patients with or with out co-morbid conditions with Category-I regimen appears to be appropriate.
authors.affiliation: Tuberculosis Research Centre (ICMR), Chennai, India.
authors.forename: V V
authors.initials: VV
authors.lastname: Banu Rekha
authors.forename: Rani
authors.initials: R
authors.lastname: Balasubramanian
authors.forename: Soumya
authors.initials: S
authors.lastname: Swaminathan
authors.forename: Rajeswari
authors.initials: R
authors.lastname: Ramachandran
authors.forename: Fathima
authors.initials: F
authors.lastname: Rahman
authors.forename: V
authors.initials: V
authors.lastname: Sundaram
authors.forename: K
authors.initials: K
authors.lastname: Thyagarajan
authors.forename: N
authors.initials: N
authors.lastname: Selvakumar
authors.forename: A R
authors.initials: AR
authors.lastname: Adhilakshmi
authors.forename: Sheik
authors.initials: S
authors.lastname: Iliayas
authors.forename: P R
authors.initials: PR
authors.lastname: Narayanan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005260:Female; D015658:HIV Infections / Q000503:physiopathology*; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology*; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents