       Document 0230
 DOCN  M9630230
 TI    Two-year follow-up of persons with HIV-1- and HIV-2-associated pulmonary
       tuberculosis treated with short-course chemotherapy in West Africa.
 DT    9603
 AU    Kassim S; Sassan-Morokro M; Ackah A; Abouya LY; Digbeu H; Yesso G;
       Coulibaly IM; Coulibaly D; Whitaker PJ; Doorly R; et al; Centres
       Antituberculeux, Abidjan, Cote d'Ivoire.
 SO    AIDS. 1995 Oct;9(10):1185-91. Unique Identifier : AIDSLINE MED/96098136
 AB    OBJECTIVE: To assess the response to therapy for tuberculosis using
       rifampicin-containing short-course chemotherapy, and to compare
       recurrence and mortality rates in seronegative persons and those with
       HIV-1, HIV-2, and dual serologic reactivity in West Africa. METHODS: A
       cohort of 835 adult patients (167 HIV-1-positive, 143 HIV-2-positive,
       243 dual-reactive, 282 HIV-negative) with smear-positive pulmonary
       tuberculosis was followed for 2 years under programme conditions.
       Standard self-administered treatment was daily rifampicin and isoniazid
       for 6 months, and in addition pyrazinamide during the first 2 months.
       Outcomes evaluated were rates of completion of therapy, cure, failure of
       treatment, recurrence after cure, and mortality. RESULTS: HIV-positive
       patients had lower rates of completion of therapy (65-73%) than
       seronegative patients (79%), mainly because of increased mortality.
       Among patients completing therapy, failure of treatment was similarly
       low in HIV-positive (2%) and seronegative patients (1%). Recurrence
       rates after cure did not differ significantly in the 18 months of
       follow-up in the four serologic groups (3-7%). The respective mortality
       rates for HIV-1-positive, HIV-2-positive, and dually reactive patients
       were 20.3, 8.3, and 25.5 per 100 person-years (PY), compared with 2.2
       per 100 PY among seronegatives. CONCLUSIONS: Rifampicin-containing
       short-course chemotherapy for pulmonary tuberculosis is associated with
       similar cure and recurrence rates in HIV-positive and HIV-negative
       persons completing 6 months of therapy. HIV-2 infection is associated
       with more favourable survival than HIV-1 infection or dual reactivity,
       even when AIDS-defining illness is already present. However, mortality
       is significantly increased in all seropositive groups compared with
       HIV-negative tuberculosis patients; thus, establishing the causes of
       this increased mortality is a priority.
 DE    Adolescence  Adult  Africa, Western  Antibiotics,
       Antitubercular/*THERAPEUTIC USE  Antitubercular Agents/THERAPEUTIC USE
       AIDS-Related Opportunistic Infections/COMPLICATIONS/*DRUG THERAPY/
       MORTALITY  Drug Therapy, Combination  Female  Follow-Up Studies  Human
       HIV Seronegativity  HIV Seropositivity/*COMPLICATIONS  *HIV-1  *HIV-2
       Isoniazid/THERAPEUTIC USE  Male  Pyrazinamide/THERAPEUTIC USE
       Recurrence  Rifampin/*THERAPEUTIC USE  Treatment Failure  Tuberculosis,
       Pulmonary/COMPLICATIONS/*DRUG THERAPY/MORTALITY  CLINICAL TRIAL  JOURNAL
       ARTICLE

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

