title: Weight gain and response to treatment for multidrug-resistant tuberculosis.
abstract: Alternatives to culture are needed in high burden countries to assess whether response to treatment of multidrug-resistant-tuberculosis (MDR-TB) is satisfactory. The objective was to assess the association of weight gain and treatment outcome. The methods included analysis of clinical, bacteriologic, and weight from 439 MDR-TB patients in the Philippines. Odds ratios (ORs) were calculated to determine whether 5% weight gain during the first 6 months of treatment was associated with outcome. Three hundred and ten (71%) patients were cured and 129 (29%) had poor outcomes (death, defaulted, or failed treatment). Fifty-three percent were underweight (body mass index [BMI] < 18.5 kg/m(2)) before treatment. Five percent weight gain after completing 3 months of treatment was associated with good outcome among patients who were underweight before treatment (OR 2.1; 95% confidence interval [CI], 1.05 to 4.4). Baseline weight and degree of weight change during the first 6 months of treatment can help identify persons who are more likely to have poor outcomes and require other interventions.
authors.affiliation: Tropical Disease Foundation, Makati City, Philippines; Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia; Tuberculosis Research Unit, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio.
authors.forename: Ma Tarcela
authors.initials: MT
authors.lastname: Gler
authors.forename: Ruffy
authors.initials: R
authors.lastname: Guilatco
authors.forename: Janice C
authors.initials: JC
authors.lastname: Caoili
authors.forename: Julia
authors.initials: J
authors.lastname: Ershova
authors.forename: Peter
authors.initials: P
authors.lastname: Cegielski
authors.forename: John L
authors.initials: JL
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000032:analysis; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects; D010679:Philippines / Q000453:epidemiology; D016019:Survival Analysis; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology / Q000401:mortality; D015430:Weight Gain
chemical_list: D000995:Antitubercular Agents; D015415:Biomarkers
references.citation: Lancet. 2012 Oct 20;380(9851):1406-17
references.pmid: 22938757
references.citation: Int J Tuberc Lung Dis. 2007 Dec;11(12):1314-20
references.pmid: 18034952
references.citation: Indian J Tuberc. 2008 Jan;55(1):15-21
references.pmid: 18361306
references.citation: Indian J Tuberc. 2009 Jan;56(1):5-9
references.pmid: 19402266
references.citation: Eur J Clin Nutr. 1988 Apr;42(4):363-6
references.pmid: 3396528
references.citation: Am J Respir Crit Care Med. 2010 Sep 1;182(5):684-92
references.pmid: 20442432
references.citation: Am J Respir Crit Care Med. 2008 Nov 15;178(10):1075-82
references.pmid: 18703792
references.citation: N Engl J Med. 2009 Jun 4;360(23):2397-405
references.pmid: 19494215
references.citation: Int J Tuberc Lung Dis. 2005 Jun;9(6):640-5
references.pmid: 15971391
references.citation: Am J Respir Crit Care Med. 2006 Aug 1;174(3):344-8
references.pmid: 16709935
references.citation: Eur J Clin Nutr. 1988 May;42(5):445-50
references.pmid: 3396531
references.citation: Tuberculosis (Edinb). 2011 Nov;91(6):601-4
references.pmid: 21813327
references.citation: Int J Tuberc Lung Dis. 2011 May;15(5):652-6
references.pmid: 21756517
references.citation: Clin Infect Dis. 2008 Jun 15;46(12):1844-51
references.pmid: 18462099
references.citation: N Engl J Med. 2003 Jan 9;348(2):119-28
references.pmid: 12519922
references.citation: Int J Tuberc Lung Dis. 2008 Oct;12(10):1153-9
references.pmid: 18812045
references.citation: Int J Tuberc Lung Dis. 2013 Jan;17(1):61-6
references.pmid: 23146565
references.citation: Bull World Health Organ. 1995;73(5):673-80
references.pmid: 8846494
references.citation: Am J Clin Nutr. 1998 Oct;68(4):899-917
references.pmid: 9771869