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J Glob Antimicrob Resist. 2018 Sep;14:104-108. doi: 10.1016/j.jgar.2018.02.015. Epub 2018 Feb 26.

Association between antiretroviral therapy and antitubercular drug resistance in TB treatment outcome among Kazakh TB/HIV co-infected patients.

Author information

1
Global Institute for Health and Human Rights, University at Albany, State University of New York (SUNY), Albany, NY, USA.
2
Rockefeller College, University at Albany, State University of New York (SUNY), Albany, NY, USA; Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany, State University of New York (SUNY), Albany, NY, USA; Institute for International Health and Education, Albany, NY, USA.
3
Department of Population Health and Social Sciences, Kazakhstan School of Public Health, Almaty, Kazakhstan.
4
Institute for International Health and Education, Albany, NY, USA. Electronic address: alaeiarash@gmail.com.

Abstract

OBJECTIVES:

Drug-resistant tuberculosis (TB) poses a serious threat to public health in Kazakhstan. This paper presents findings related to TB treatment outcome and drug resistance status among people co-infected with human immunodeficiency virus (HIV) and TB in Kazakhstan.

METHODS:

A cohort study using data provided by the Kazakhstan Ministry of Health's National Tuberculosis Program for 2014 and 2015 was performed. The χ2 test and logistical regression were performed to understand factors associated with drug-resistant TB status and TB treatment outcome.

RESULTS:

In the bivariate analysis, drug-resistant TB status was significantly associated with year of TB diagnosis (P=0.001) and viral load (P=0.03). TB treatment outcome was significantly associated with age at diagnosis (p=0.01), antiretroviral (ARV) treatment (P<0.0001) and drug-resistant TB status (P=0.02). In the adjusted analysis, drug-resistant TB status was associated with an increased likelihood of successful completion of treatment with a successful outcome compared with treatment failure (odds ratio=6.94, 95% confidence interval 1.39-34.44).

CONCLUSIONS:

These results suggest that having drug-resistant TB is associated with a higher likelihood of completing treatment with successful outcome, even when controlling for receipt of ARV therapy.

KEYWORDS:

AIDS; Central Asia; Drug resistance; HIV; Tuberculosis

PMID:
29496619
DOI:
10.1016/j.jgar.2018.02.015
[Indexed for MEDLINE]

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