HIV infection and multiple drug resistant tuberculosis: the frequency of co-infection and treatment efficacy
https://doi.org/10.21292/2075-1230-2021-99-2-45-51
Abstract
The objective of the study: in Tomsk Region, to establish the frequency of multiple drug resistance (MDR) of mycobacterium tuberculosis (MBT) in new tuberculosis patients with the reference to their HIV status and to assess their treatment outcomes.
Subjects and methods. The presented results were obtained from a retrospective cohort study of 788 new tuberculosis patients who were registered for MDR TB treatment at Tomsk Phthisiopulmonology Medical Center from January 2017 to April 2019.
Results. In Tomsk Region, the level of primary MDR reaches 31.3% in patients with TB/HIV co-infection, while in HIV negative tuberculosis patients, this rate is 24.2%. The incidence of primary MDR/XDR MTB reaches 40% among deceased patients with TB/HIV co-infection. Treatment efficacy in MDR/XDR TB patients with associated HIV infection is low – the effective treatment was achieved only in 7.3% of them. In general (excluding the data on MTB drug resistance and antiretroviral therapy), treatment efficacy of tuberculosis patients with HIV infection is significantly lower versus HIV negative tuberculosis patients: 37.7% and 61.9%, respectively, OR 0.38 [0.28; 0.50], p = 0.001.
About the Authors
O. V. Filinyuk
Siberian State Medical University
Russian Federation
Russian Federation
Olga V. Filinyuk, Doctor of Medical Sciences, Associate Professor, Head of Phthisiology and Pulmonology Department
2, Moskovsky Tr., Tomsk. 634050
A. S. Alliluev
Siberian State Medical University; Tomsk Phthisiopulmonology Medical Center
Russian Federation
Russian Federation
Aleksandr S. Alliluev, Post-graduate Student of Phthisiology and Pulmonology Department
2, Moskovsky Tr., Tomsk. 634050
26, Kuznetsova St., Tomsk, 634041
D. E. Аmichba
Siberian State Medical University
Russian Federation
Russian Federation
Dmitry E. Аmichba, Resident of Phthisiology and Pulmonology Department
2, Moskovsky Tr., Tomsk. 634050
P. N. Golubchikov
Tomsk Phthisiopulmonology Medical Center
Russian Federation
Petr N. Golubchikov, Deputy Head Physician for Medical Activities
Russian Federation
Petr N. Golubchikov, Deputy Head Physician for Medical Activities
26, Kuznetsova St., Tomsk, 634041
Yu. S. Popelo
Siberian State Medical University
Russian Federation
Russian Federation
Yulia S. Popelo, Resident of X-ray Diagnostics and X-ray Therapy Department
2, Moskovsky Tr., Tomsk. 634050
M. N. Dobkina
Siberian State Medical University; Tomsk Center for AIDS and Infectious Diseases Prevention and Control
Russian Federation
Russian Federation
Marina N. Dobkina, Candidate of Medical Sciences, Assistant of Infections Diseases and Epidemiology Department
2, Moskovsky Tr., Tomsk. 634050
References
1. Аshenova G.Zh., Galkin V.B., Zagdyn Z.M. et al. TB/VICH v Rossiyskoy Federatsii. Epidemiologiya, osobennosti klinicheskikh proyavleniy i rezultaty lecheniya. [TB/HIV in the Russian Federation. Epidemiology, specific clinical manifestations and treatment outcomes]. S.A. Sterlikov, eds., Moscow, RIO TSNIIOIZ Publ., 2018, 67 p. https://mednet.ru/images/stories/files/CMT/mono2018.pdf.
2. Viktorova I.B., Khanin А.L., Zimina V.N. Deaths in patients with HIV infection in a large TB institution in Kemerovo Region. Journal Infektologii, St. Peterburg, 2017, vol. 9, no. 3, pp. 25-31. (In Russ.) doi 10.22625/2072.
3. Golubchikov P.N., Kruk E.А., Mishustin S.P., Petrenko T.I., Kudlay D.А. Experience of treating extensive drug resistant tuberculosis patients including continuous use of bedaquiline, in Tomsk Region: immediate and postponed results. Tuberculosis and Lung Diseases, 2019, vol. 97, no. 8, pp. 38-45. (In Russ.)
4. Zimina V.N., Mikova O.E., Varetskaya T.А., Oborin D.А., Degtyareva S.Yu., Sergevnin V.I. The pattern of primary drug resistance of Mycobacterium tuberculosis in tuberculosis patients depending on HIV status. Terapevticheskiy Arkhiv, 2017, no. 11 (89), pp. 50-54. (In Russ.)
5. Kaminskiy G.D., Kudlay D.А., Panova А.E., Parolina L.E., Peregudova А.B., Pshenichnaya N.Yu., Samoylova А.G., Testov V.V., Tinkova V.V. Taktika vracha pri vyyavlenii, diagnostike i profilaktike sochetannoy infektsii VICH i tuberkulez: prakticheskoe rukovodstvo. [Tactics of the physician in the detection, diagnosis and prevention of TB/HIV co-infection. Practical guide]. I.A. Vasilyeva, eds., Moscow, 2020, 152 p.
6. Krasnov V.А., Revyakina O.V., Filippova O.P., Pavlenok I.V., Mitrofanov R.А. Osnovnye pokazateli protivotuberkuleznoy deyatelnosti v Sibirskom i Dalnevostochnom federalnom okruge. [Main indicators of tuberculosis control activities in the Siberian and Far Eastern Federal Districts]. Novosibirsk, Izdatelsko-Poligraficheskiy Tsentr NGMU Publ., 2019, 96 p.
7. Mamaev А.N., Kudlay D.А. Statisticheskiye metody v meditsine. [Statistical methods in medicine]. Moscow, Prakticheskaya Meditsina Publ., 2021, 136 p. ISBN 978-5-98811-635-6.
8. Popov S.А., Sabgayda T.P., Radina T.S. Assessment of correlation between HIV infection and tuberculosis with multiple drug resistance. Tuberculosis and Lung Diseases, 2018, vol. 96
9. Stavitskaya N.V., Felker I.G., Zhukova E.M., Tlif А.I., Doktorova N.P., Kudlay D.А. The multivariate analysis of the results of bedaquiline use in the therapy of MDR/XDR pulmonary tuberculosis. Tuberculosis and Lung Diseases, 2020, vol. 98, no. 7, pp. 56-62. (In Russ.)
10. Tikhonova L.Yu., Sokolova V.V., Tarasyuk I.А., Ekimenko А.M., Cherenkova M.А., Kudlay D.А. Experience of treatment of multiple drug resistant tuberculosis patients with bedaquiline in Amur Region. Tuberculosis and Lung Diseases, 2018, vol. 96, no. 6, pp. 45-50. (In Russ.)
11. Аkanbi M. O., Achenbach C., Taiwo B et al. Evaluation of Gene Xpert for routine diagnosis of HIV-associated tuberculosis in Nigeria: a prospective cohort study // BMC Pulm. Med. – 2017. – Vol. 17, № 87. doi:10.1186/s12890-017-0430-6.
12. Chem E. D., Van Hout M. C., Hope V. Treatment outcomes and antiretroviral uptake in multidrug-resistant tuberculosis and HIV co-infected patients in Sub Saharan Africa: a systematic review and meta-analysis // BMC Infect. Dis. – 2019. – Vol. 19, № 1. – Р. 723. doi:10.1186/s12879-019-4317-4.
13. Dagnra A. Y., Mlaga K. D., Adjoh K., Kadanga E., Disse K., Adekambi T. Prevalence of multidrug-resistant tuberculosis cases among HIV-positive and HIV-negative patients eligible for retreatment regimen in Togo using GeneXpert MTB/RIF // New Microbe New Infect. – 2015. – Vol. 8. – P. 24-27. doi:10.1016/j.nmni.2015.09.001.
14. Isaakidis P., Casas E. C., Das M. et al. Treatment outcomes for HIV and MDR-TB co-infected adults and children: systematic review and meta-analysis // Int. J. Tuberc. Lung Dis. ‒ 2015. ‒ № 8 (19). ‒ P. 969-978.
15. Khanin A., Viktorova I., Kononchuk O. Primary drug resistance in HIV/tuberculosis patients in two large cities of Siberia // Eur. Respir. J. ‒ 2016. ‒ № 48. ‒ PA2765; doi: 10.1183/13993003.
16. Lawn S. D., Brooks S. V., Kranzer K. et al. Screening for HIV-associated tuberculosis and rifampicin resistance before antiretroviral therapy using the xpert MTB/RIF assay: a prospective study // PLoS Med. – 2011. – Vol. 8, № 7. ‒ Р. e1001067. doi:10.1371/journal.pmed.1001067.
17. Magee M. J., Blumberg H. M., Broz D. et al. Prevalence of drug resistant tuberculosis among patients at high-risk for HIV attending outpatient clinics in Delhi India // Southeast Asian. J. Trop. Med. Public Health. – 2012. – Vol. 43, № 2. – P. 354-363.
18. Raizada N., Sachdeva K.S., Sreenivas A. et al. Catching the missing million: experiences in enhancing TB & DR-TB detection by providing upfront Xpert MTB/RIF testing for people living with HIV in India // PLoS One. – 2015. – Vol. 10, № 2. :e0116721. doi:10.1371/journal.pone.0116721.
19. Saldanha N., Runwal K., Ghanekar C., Gaikwad S., Sane S., Pujari S. High prevalence of multi drug resistant tuberculosis in people living with HIV in Western Indias // BMC Infect. Dis. – 2019. – Vol. 19, № 391. doi. org/10.1186/s12879-019-4042-z.
20. Singh A., Prasad R., Balasubramanian V., Gupta N. Drug-resistant tuberculosis and HIV infection: current perspectives HIV/AIDS // Res. Palliat. Care. – 2020. – Vol. – 12. – P. 9-31. doi.org/10.2147/HIV.S193059.
Review
For citations:
Filinyuk O.V., Alliluev A.S., Аmichba D.E., Golubchikov P.N., Popelo Yu.S., Dobkina M.N. HIV infection and multiple drug resistant tuberculosis: the frequency of co-infection and treatment efficacy. Tuberculosis and Lung Diseases. 2021;99(2):45-51. (In Russ.) https://doi.org/10.21292/2075-1230-2021-99-2-45-51
Views:
1237
Email this article 