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Int J Tuberc Lung Dis. 2008 Sep;12(9):1059-64.

The value of end-of-treatment chest radiograph in predicting pulmonary tuberculosis relapse.

Author information

1
Division of Infectious Diseases & International Health, Duke University Medical Center, Durham, North Carolina 27710, USA. dukes002@mc.duke.edu

Abstract

SETTING:

Patients with cavitary pulmonary tuberculosis (TB) on baseline chest radiograph (CXR) who remain culture-positive after 8 weeks of treatment are at high risk of relapse. The role of end-of-treatment (EOT) CXR in predicting relapse is unclear.

OBJECTIVE:

To determine whether EOT CXR independently predicts TB relapse.

DESIGN:

We conducted a secondary analysis of a randomized trial of intermittent treatment using rifapentine in the continuation phase of TB treatment among 1004 human immunodeficiency virus seronegative adults with culture-proven pulmonary TB.

RESULTS:

Relapse occurred in 17.3% of subjects with persistent cavity on EOT CXR, in 7.6% of subjects with a cavity that resolved by EOT, and 2.5% (P=0.002 for trend) of subjects who never had a cavity. In multivariable analysis, patients with persistent cavity on EOT CXR were significantly more likely to relapse than patients with no cavity on baseline or 2-month CXR (hazard ratio [HR] 4.22, 95%CI 2.00-8.91), and were more likely to relapse than subjects whose early cavity had resolved by EOT CXR (HR 1.92, 95%CI 1.09-3.39).

CONCLUSION:

A persistent cavity after 6 months of TB treatment was independently associated with disease relapse after controlling for other variables. EOT CXR may help predict those likely to relapse.

PMID:
18713505
PMCID:
PMC3785322
[Indexed for MEDLINE]
Free PMC Article

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