TY - JOUR
T1 - Treatment outcomes in patients with drug-resistant TB-HIV coinfection treated with bedaquiline and linezolid
AU - Padayatchi, N.
AU - Bionghi, N.
AU - Osman, F.
AU - Naidu, N.
AU - Ndjeka, N.
AU - Master, I.
AU - Brust, J. C.M.
AU - Naidoo, K.
AU - Ramjee, A.
AU - O'Donnell, M.
N1 - Funding Information:
This work was supported by the South African Medical Research Council (Pretoria, South Africa). NP, NN and KN are supported by the Centre for the AIDS Programme of Research in South Africa (Durban, South Africa). MOD was supported by the Herbert and Florence Irving Foundation, New York City, NY, USA; and by the US National Institutes of Health (NIH), Bethesda, MD, USA (R01AI124413). JB was supported by the US NIH (R01AI114304) and the Einstein-Rockefeller-CUNY Center for AIDS Research (New York, NY, USA; P30AI124414). Conflicts of interest: none declared.
Publisher Copyright:
© 2020 The Union
PY - 2020/10/1
Y1 - 2020/10/1
N2 - BACKGROUND: Bedaquiline (BDQ) has not been extensively studied among patients co-infected with HIV drug-resistant tuberculosis (DR-TB). We compared treatment outcomes in DR-TB patients treated with BDQ- and linezolid (LZD) containing regimens to historic controls treated with second-line injectable-containing regimens. METHODS: Retrospective cohort study of consecutive DR-TB patients initiated on BDQ- and LZD-containing regimens at a TB referral hospital in KwaZulu-Natal, South Africa. Participants were prospectively followed through 24 months for treatment outcome and adverse events. Outcomes were compared to a historic control cohort of DR-TB HIV patients enrolled at the same facility prior to BDQ introduction. R E S U LT S: Adult DR-TB patients initiating BDQ between January 2014 and November 2015 were enrolled (n ¼ 151). The majority of patients were female (52%), HIV co-infected (77%) and on antiretroviral therapy (100%). End of treatment outcomes included cure (63%), TB culture conversion (83%), completion (0.7%), loss to follow-up (15%), treatment failure (5%), and death (17%). Compared to historic controls (n ¼ 105), patients treated with BDQ experienced significantly higher TB culture conversion and cure, with significantly lower mortality. Adverse effects were common (92%), and most frequently attributed to LZD (24.1%). QT segment prolongation was common but without clinical sequelae. CONCLUSION: Treatment with BDQ- and LZD-containing regimens was associated with improved treatment outcomes and survival in DR-TB HIV patients.
AB - BACKGROUND: Bedaquiline (BDQ) has not been extensively studied among patients co-infected with HIV drug-resistant tuberculosis (DR-TB). We compared treatment outcomes in DR-TB patients treated with BDQ- and linezolid (LZD) containing regimens to historic controls treated with second-line injectable-containing regimens. METHODS: Retrospective cohort study of consecutive DR-TB patients initiated on BDQ- and LZD-containing regimens at a TB referral hospital in KwaZulu-Natal, South Africa. Participants were prospectively followed through 24 months for treatment outcome and adverse events. Outcomes were compared to a historic control cohort of DR-TB HIV patients enrolled at the same facility prior to BDQ introduction. R E S U LT S: Adult DR-TB patients initiating BDQ between January 2014 and November 2015 were enrolled (n ¼ 151). The majority of patients were female (52%), HIV co-infected (77%) and on antiretroviral therapy (100%). End of treatment outcomes included cure (63%), TB culture conversion (83%), completion (0.7%), loss to follow-up (15%), treatment failure (5%), and death (17%). Compared to historic controls (n ¼ 105), patients treated with BDQ experienced significantly higher TB culture conversion and cure, with significantly lower mortality. Adverse effects were common (92%), and most frequently attributed to LZD (24.1%). QT segment prolongation was common but without clinical sequelae. CONCLUSION: Treatment with BDQ- and LZD-containing regimens was associated with improved treatment outcomes and survival in DR-TB HIV patients.
KW - BDQ
KW - DR-TB
KW - Human immunodeficiency virus
KW - LZD
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U2 - 10.5588/IJTLD.20.0048
DO - 10.5588/IJTLD.20.0048
M3 - Article
C2 - 33126934
AN - SCOPUS:85094933596
VL - 24
SP - 1024
EP - 1031
JO - International Journal of Tuberculosis and Lung Disease
JF - International Journal of Tuberculosis and Lung Disease
SN - 1027-3719
IS - 10
ER -