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Current Infectious Disease Reports

Erschienen in:

01.05.2010

Global Impact of Multidrug-Resistant Pulmonary Tuberculosis Among HIV-Infected and Other Immunocompromised Hosts: Epidemiology, Diagnosis, and Strategies for Management

verfasst von: Charles D. Wells

Erschienen in: Current Infectious Disease Reports | Ausgabe 3/2010

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Abstract

Multidrug-resistant (MDR) tuberculosis (TB), or TB caused by strains of Mycobacterium tuberculosis resistant to at least isoniazid and rifampicin, represents a major threat to global TB control. Comprising more than 5% of all TB cases annually worldwide, these cases require treatment duration of 2 years on average with expensive and toxic second-line anti-TB drugs. Cure rates are far lower and mortality far higher than for drug-susceptible TB, particularly if patients are coinfected with HIV. Use of rapid diagnostic tools and assessment of risk factors for MDR TB, as well as rapid initiation of MDR TB treatment as recommended by the World Health Organization, including use of appropriate empiric regimens as necessary, is essential to achieving good outcomes from treatment. Rapid initiation of antiretroviral therapy (ART) for those with HIV coinfection, as well as strategic management of overlapping side effects from ART and first and second-line drugs for treating MDR TB to maintain patients on treatment are critical to patient survival and achieving good treatment outcomes. Employing sensible infection control practices in the context of diagnosis and treatment is essential to reducing transmission of MDR TB strains among patient populations and healthcare personnel.

World Health Organization: Antituberculosis Drug Resistance in the World: Fourth Global Report. WHO/HTM/TB/2008.394. Available at http://www.who.int/tb/publications/2008/en/index.html. Accessed February 2010.

World Health Organization: Global Tuberculosis Control: Epidemiology, Strategy, Financing: WHO Report 2009. WHO/HTM/TB/2009.411. Available at http://www.who.int/tb/publications/2008/en/index.html. Accessed February 2010.

• World Health Organization: Guidelines for the Programmatic Management of Drug-Resistant Tuberculosis: Emergency Update 2008. Available at http://www.who.int/tb/publications/2008/en/index.html. Accessed February 2010. These consensus-derived and updated guidelines, published in 2008, represent the most comprehensive overview of MDR TB epidemiology, diagnosis, and treatment, and co-management of MDR TB and HIV. They are widely used by MDR TB programs throughout the world as a basis for policy and practice and present a wealth of information derived from the most current evidence base.

Leimane V, Riekstina V, Holtz TH, et al.: Clinical outcome of individualised treatment of multidrug resistant tuberculosis in Latvia: a retrospective cohort study. Lancet 2005, 365:318–26.PubMed

Tupasi TE, Gupta R, Quelapio MID, et al.: Feasibility and cost-effectiveness of treating multidrug-resistant tuberculosis: a cohort study in the Philippines. PLoS Med 2006, 3:e352.CrossRefPubMed

Mitnick CD, Shin SS, Seung KJ, et al.: Comprehensive Treatment of Extensively Drug-Resistant Tuberculosis. N Engl J Med, 2008, 359:563–574.CrossRefPubMed

Keshavjee S, Gelmanova IY, Farmer PE, et al.: Treatment of extensively drug-resistant tuberculosis in Tomsk, Russia: a retrospective cohort study. Lancet 2008, 372:1403–1409.CrossRefPubMed

• Orenstein EW, Basu S, Shah NS, et al.: Treatment outcomes among patients with multidrug-resistant tuberculosis: systematic review and meta-analysis. Lancet Infect Dis 2009, 9:153–161. Taken together, the two independently conducted meta-analyses of the existing published clinical studies evaluating MDR TB treatment and outcomes reported in references 8 and 9 provide useful information regarding approaches to treatment, overall treatment success, and factors influencing outcomes. Because limited data are available on MDR TB treatment from controlled clinical trials, these reviews of the body of published cohort and case-control studies provide important (and independent) analyses of the evidence base for shaping treatment policy.

• Johnston JC, Shahidi NC, Sadatsafavi M, Fitzgerald JM. Treatment outcomes of multidrug-resistant tuberculosis: a systematic review and meta-analysis. PLoS ONE 4:e6914. Taken together, the two independently conducted meta-analyses of the existing published clinical studies evaluating MDR TB treatment and outcomes reported in references 8 and 9 provide useful information regarding approaches to treatment, overall treatment success, and factors influencing outcomes. Because limited data are available on MDR TB treatment from controlled clinical trials, these reviews of the body of published cohort and case-control studies provide important (and independent) analyses of the evidence base for shaping treatment policy.

10.

World Health Organization/Stop TB Partnership: Report from 7th Meeting of Stop TB Partnership Working Group on Multidrug Resistant Tuberculosis. Geneva, Switzerland; October 12, 2009.

11.

Reid A, Scano F, Getahun H, et al.: Towards universal access to HIV prevention, treatment, care, and support: the role of TB/HIV collaboration. Lancet Infect Dis 2006, 6:483–495.CrossRefPubMed

12.

Ghandi NR, Moll A, Sturm AW, et al.: Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa. Lancet 2006, 368:1554–1556.CrossRef

13.

Wells CD, Cegielski JP, Nelson LJ, et al.: HIV infection and multidrug-resistant tuberculosis—the perfect storm. J Infect Dis 2007, 196:S86–S107.CrossRefPubMed

14.

Nelson LJ, Talbot EA, Mwasekaga MJ, et al.: Antituberculosis drug resistance and anonymous HIV surveillance in tuberculosis patients in Botswana, 2002. Lancet 2005, 366:488–490.CrossRefPubMed

15.

AIDSmap News: Two XDR TB cases reported in Botswana—January 2008. Available at http://www.aidsmap.com/en/news/1B5F0A58-9125-461F-9F37-36CC930B6E79.asp. Accessed February 2010.

16.

Vernon A, Burman W, Benator D, et al.: Acquired rifamycin monoresistance in patients with HIV-related tuberculosis treated with once-weekly rifapentine and isoniazid. Tuberculosis Trials Consortium. Lancet 1999, 353:1843–1847.CrossRefPubMed

17.

Lutfey M, Della-Latta P, Kapur V, et al.: Independent origin of monorifampin-resistant Mycobacterium tuberculosis in patients with AIDS. Am J Respir Crit Care Med 1996, 153:837–840.PubMed

18.

Centers for Disease Control and Prevention (CDC): Trends in tuberculosis—United States, 2007. MMWR Morb Mortal Wkly Rep 2008,57:281–285.

19.

Centers for Disease Control and Prevention (CDC): Plan to combat extensively drug-resistant tuberculosis: recommendations of the Federal Tuberculosis Task Force. MMWR Recomm Rep 2009, 58(RR-3):1–43.

20.

Jeon CY, Murray MB: Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. PLoS Med 2008, 5:e152.CrossRefPubMed

21.

Suarez-Garcia I, Rodríguez-Blanco A, Vidal-Pérez JL, et al.: Risk factors for multidrug-resistant tuberculosis in a tuberculosis unit in Madrid, Spain. Eur J Clin Microbiol Infect Dis 2009, 28:325–330.CrossRefPubMed

22.

Fisher-Hoch SP, Whitney E, McCormick JB, et al.: Type 2 diabetes and multidrug-resistant tuberculosis. Scand J Infect Dis 2008, 40:888–893.CrossRefPubMed

23.

Soria ML, Sy RG, Vega BS, et al.: The incidence of type 2 diabetes mellitus in the Philippines: a 9-year cohort study. Diabetes Res Clin Pract 2009, 86:130–133.CrossRefPubMed

24.

Asonio C, Tupasi T, Quelapio M, et al.: Diabetes mellitus in MDR TB in the Philippines. Abstract PS-95425-07 presented at the 40th Union World Conference on Lung Health. Cancun, Mexico: December 3–7, 2009. Int J Tuberc Lung Dis 2009, 13:S391.

25.

World Health Organization: Treatment of Tuberculosis: Guidelines for National Programmes, edn 3, 2003. Available at http://www.who.int/tb/publications/2004/en/index.html. Accessed February 2010.

26.

Matteelli A, Richardson MD, Sotgiu G, et al.: Multidrug and extensively drug-resistant TB in persons living with HIV. Expert Rev Respir Med 2009, 3:245–254.CrossRefPubMed

27.

Balabanova Y, Drobniewski F, Nikolayevskyy V, et al.: An integrated approach to rapid diagnosis of tuberculosis and multidrug resistance using liquid culture and molecular methods in Russia. PLoS ONE 2009, 4:e7129.CrossRefPubMed

28.

Hanna BA, Ebrahimzadeh A, Elliott LB, et al.: Multicenter evaluation of the BACTEC MGIT 960 system for recovery of mycobacteria. J Clin Microbiol 1999, 37:748–752.PubMed

29.

Traore H, Fissette K, Bastian I, et al.: Detection of rifampicin resistance in Mycobacterium tuberculosis isolates from diverse countries by a commercial line probe assay as an initial indicator of multidrug resistance. Int J Tuberc Lung Dis 2000, 4:481–484.PubMed

30.

Barbard M, Albert H, Coetzee G, et al.: Rapid molecular screening for multidrug-resistant tuberculosis in a high-volume public health laboratory in South Africa. Am J Respir Crit Care Med 2008, 177:787–792.CrossRef

31.

Helb D, Jones M, Story E, et al.: Rapid detection of Mycobacterium tuberculosis and rifampin resistance by use of on-demand, near-patient technology. J Clin Microbiol 2010, 48:229–237.CrossRefPubMed

32.

Moore DA, Evans CA, Gilman RH, et al.: Microscopic-observation drug-susceptibility assay for the diagnosis of TB. N Engl J Med 2006, 355:1539–1550.CrossRefPubMed

33.

Park WG, Bishai WR, Chaisson RE, Dorman SE: Performance of the microscopic observation drug susceptibility assay in drug susceptibility testing for Mycobacterium tuberculosis. J Clin Microbiol 2002, 40:4750–4752.CrossRefPubMed

34.

Asencios L, Yale G, Yagui M, et al.: Programmatic implementation of rapid DST for Mycobacterium tuberculosis in Peru. Int J Tuberc Lung Dis 2008, 12:743–749.PubMed

35.

Scano F, Vitoria M, Burman W, et al.: Management of HIV-infected patients with MDR TB and XDR TB in resource-limited settings. Int J Tuberc Lung Dis 2008, 12:1370–1375.PubMed

36.

• Holtz TH, Sternberg M, Kammerer S, et al.: Time to sputum culture conversion in multidrug-resistant tuberculosis: predictors and relationship to treatment outcome. Ann Intern Med 2006, 144:650–659. This article provides an in-depth and well-conducted analysis of factors associated with favorable treatment outcomes among a cohort of MDR TB patients treated in Latvia. It is one of the few analyses published to date that actually demonstrates the strong correlation between sputum culture conversion, including when it occurs, and final treatment outcome. This reference is one of the most widely cited references on treatment and has been used extensively as a basis for clinical trial design assessing new treatment strategies and drugs for MDR TB.

37.

• Seung KJ, Omatayo DB, Keshavjee S, et al.: Early outcomes of MDR-TB treatment in a high HIV-prevalence setting in Southern Africa. PLoS One 2009, 4:e7186. This report of early success in treating HIV-infected MDR TB patients in the very resource-constrained setting of Lesotho in Southern Africa demonstrates the great utility of HIV testing, rapid anti-TB drug susceptibility testing, epidemiologic assessment, use of early empiric treatment for MDR TB, and early initiation of ART for HIV as critical to improving the abysmal mortality previously documented among HIV-infected MDR TB patients. This analysis is the first substantive evidence to support the consensus-derived recommendations for managing HIV-infected MDR TB patients outlined in “Guidelines for the Programmatic Management of Drug-Resistant Tuberculosis: Emergency Update 2008” from WHO.

38.

Furin JJ, Mitnick CD, Shin SS, et al.: Occurrence of serious adverse effects in patients receiving community-based therapy for multidrug-resistant tuberculosis. Int J Tuberc Lung Dis 2001, 5:648–655.PubMed

39.

World Health Organization: Antiretroviral Therapy for HIV Infection in Adults and Adolescents: Recommendations for a Public Health Approach (2006 revision). Available at http://www.who.int/entity/hiv/pub/guidelines/adult/en/index.html. Accessed February 2010.

40.

World Health Organization: WHO Policy on TB Infection Control in Health-Care Facilities, Congregate Settings and Households. Available at http://www.who.int/tb/publications/2009/en/index.html. Accessed February 2010.

Titel: Global Impact of Multidrug-Resistant Pulmonary Tuberculosis Among HIV-Infected and Other Immunocompromised Hosts: Epidemiology, Diagnosis, and Strategies for Management
verfasst von: Charles D. Wells
Publikationsdatum: 01.05.2010
Verlag: Current Science Inc.
Erschienen in: Current Infectious Disease Reports / Ausgabe 3/2010
Print ISSN: 1523-3847
Elektronische ISSN: 1534-3146
DOI: https://doi.org/10.1007/s11908-010-0104-5

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