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Respir Med. 2014 Apr;108(4):654-9. doi: 10.1016/j.rmed.2014.01.010. Epub 2014 Jan 27.

Risk factors for 1-year relapse of pulmonary tuberculosis treated with a 6-month daily regimen.

Author information

1
Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
2
Department of Internal Medicine, Kangwon National University, Chuncheon, South Korea.
3
Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. Electronic address: shimts@amc.seoul.kr.

Abstract

BACKGROUND:

We aimed to identify the 1-year relapse rate and risk factors for patients with pulmonary tuberculosis (TB) treated with a 6-month daily regimen.

METHODS:

A total of 317 patients with pan-susceptible pulmonary TB who completed a 6-month daily course of treatment [2HRZ(E)/4HR(E)] were retrospectively analyzed.

RESULTS:

The mean age was 50.0 ± 16.8 years and men were predominant (61.2%). All of 137 adults tested for HIV were negative. Six (1.9%) cases relapsed within one year. Relapse rate was higher in patients with a positive culture after 2 months of treatment (10.0%, p = 0.049) and in patients with both a positive culture after 2 months of treatment and cavitation on initial chest radiograph (18.2%, p = 0.015), whereas relapse rate in patients with cavitation alone was comparable to that of the total population (2.7%). Among various risk factors known to increase risk of relapse, the combined variable of cavitation and positive culture at 2 months (OR = 15.56, 95% CI 2.56-98.71, p = 0.003) was only associated with increased relapse rate in a multivariate analysis.

CONCLUSIONS:

Even with a 6-month daily treatment regimen throughout the intensive and continuation phases, the relapse rate was unacceptably high in patients with both a positive culture at 2 months of treatment and cavitation on baseline chest radiography. Intensification of treatment, such as an extension of treatment duration, should be considered in this category of patients.

KEYWORDS:

2-Month culture conversion; Cavity; Pulmonary tuberculosis; Relapse

PMID:
24518046
DOI:
10.1016/j.rmed.2014.01.010
[Indexed for MEDLINE]
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