Treatment outcomes in patients with drug-resistant TB-HIV coinfection treated with bedaquiline and linezolid

N. Padayatchi, N. Bionghi, F. Osman, N. Naidu, N. Ndjeka, I. Master, J. C.M. Brust, K. Naidoo, A. Ramjee, M. O'Donnell

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1024-1031
Number of pages8
JournalInternational Journal of Tuberculosis and Lung Disease
Volume24
Issue number10
DOIs
StatePublished - Oct 1 2020

Keywords

  • BDQ
  • DR-TB
  • Human immunodeficiency virus
  • LZD

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

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