       Document 0837
 DOCN  M9550837
 TI    Pulmonary tuberculosis in HIV-infected patients in Zaire. A controlled
       trial of treatment for either 6 or 12 months.
 DT    9505
 AU    Perriens JH; St. Louis ME; Mukadi YB; Brown C; Prignot J; Pouthier F;
       Portaels F; Willame JC; Mandala JK; Kaboto M; et al; Projet SIDA,
       Kinshasa, Zaire.
 SO    N Engl J Med. 1995 Mar 23;332(12):779-84. Unique Identifier : AIDSLINE
       MED/95166277
 AB    BACKGROUND. We studied the efficacy of a short-course regimen of
       chemotherapy for pulmonary tuberculosis in Kinshasa, Zaire. We also
       assessed whether, among patients with human immunodeficiency virus (HIV)
       infection, treatment should be extended from 6 to 12 months. METHODS.
       HIV-seropositive and HIV-seronegative outpatients with pulmonary
       tuberculosis were treated with rifampin, isoniazid, pyrazinamide, and
       ethambutol daily for two months, followed by rifampin plus isoniazid
       twice weekly for four months. The HIV-positive patients who had no
       evidence of tuberculosis were then randomly assigned to receive either
       rifampin plus isoniazid or placebo twice weekly for a further six
       months. We also followed a comparison group of HIV-seronegative patients
       who received no further treatment for tuberculosis after six months.
       RESULTS. After six months, 260 of 335 HIV-seropositive and 186 of 188
       HIV-seronegative participants could be evaluated, and their rates of
       treatment failure were similar: 3.8 and 2.7 percent, respectively. At 24
       months, the HIV-seropositive patients who received extended treatment
       had a relapse rate of 1.9 percent, as compared with 9 percent among the
       HIV-seropositive patients who received placebo for the second 6 months
       (P < 0.01). Extended treatment did not improve survival, however. Among
       the HIV-seronegative patients, 5.3 percent relapsed. CONCLUSIONS. Among
       HIV-seropositive patients with pulmonary tuberculosis, extending
       treatment from 6 to 12 months reduces the rate of relapse but does not
       improve survival. The six-month program of partly intermittent
       antituberculous treatment may be an acceptable alternative when
       resources are limited.
 DE    Adult  Antibiotics, Antitubercular/*THERAPEUTIC USE  AIDS-Related
       Opportunistic Infections/*DRUG THERAPY/MORTALITY  Female  Human  HIV
       Seropositivity  Male  Prospective Studies  Single-Blind Method  Support,
       Non-U.S. Gov't  Support, U.S. Gov't, P.H.S.  Time Factors  Treatment
       Outcome  Tuberculosis, Multidrug-Resistant  Tuberculosis,
       Pulmonary/*DRUG THERAPY/MORTALITY  CLINICAL TRIAL  JOURNAL ARTICLE
       RANDOMIZED CONTROLLED TRIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

