title: HIV-infected patients retreated for tuberculosis with intermittent Category II regimen--treatment outcome at 24-month follow-up.
abstract: BACKGROUND
  The management of tuberculosis re-treatment in HIV-infected individuals is complex. The clinical and radiological manifestations in this group and response to Category II treatment is not well described.
  
  
  METHODS
  We performed a prospective cohort study of HIV-infected patients retreated for TB due to failure, relapse or default after treatment, at Tuberculosis Research Centre, Chennai, between February 2001 to September 2005. The Category II regimen followed in the TB programme in India (RNTCP) was administered (2 months of Streptomycin (S), Ethambutol (E), INH (H), Rifampicin (R), Pyrazinamide (Z)/1 month of EHRZ/5 months of HRE all given thrice weekly). Antiretroviral treatment was not routinely available at that time.
  
  
  RESULTS
  Of the 42 patients enrolled, 35 (83%) were males. The mean age was 33.2 (SD-6.3) years. Cough was the commonest (67%) presenting symptom and opacities were the commonest (48%) radiographic occurrence. 31 patients were culture-positive at baseline, drug susceptibility results showed that 21 (68%) were fully susceptible to all first line drugs, four patients (13%) had MDR TB and four had resistance to INH alone. Among the 31 culture-positive patients, 15 patients (48.4%) completed treatment and were declared cured, of whom two subsequently relapsed. All four MDR patients died. Six patients who received ART, survived.
  
  
  CONCLUSIONS
  Only 50% of HIV-infected, ART-naive patients who were retreated for tuberculosis using an intermittent Category II regimen had a favourable response to treatment. Early detection of MDRTB and concurrent antiretroviral therapy could contribute to improved outcomes.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Kumar
authors.forename: Pradeep A
authors.initials: PA
authors.lastname: Menon
authors.forename: C
authors.initials: C
authors.lastname: Ponnuraja
authors.forename: C
authors.initials: C
authors.lastname: Padmapriyadarsini
authors.forename: G
authors.initials: G
authors.lastname: Narendran
authors.forename: Sheik
authors.initials: S
authors.lastname: Iliayas
authors.forename: Sudha
authors.initials: S
authors.lastname: Subramanyam
authors.forename: Vanaja
authors.initials: V
authors.lastname: Kumar
authors.forename: Soumya
authors.initials: S
authors.lastname: Swaminathan
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000382:microbiology*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy* / Q000382:microbiology / Q000821:virology*
chemical_list: D000995:Antitubercular Agents