[无家可归人群潜伏性结核病的治疗。两种治疗方法的比较]

[Treatment of latent tuberculosis among homeless population. Comparison between wo therapeutic approaches].

作者信息

Sánchez-Arcilla Ignacio, Vílchez José María, García de la Torre Manuel, Fernández Xiomara, Noguerado Arturo

机构信息

Programa de Prevención y Control de la Tuberculosis. Ayuntamiento de Madrid. Madrid. Spain.

出版信息

Med Clin (Barc). 2004 Jan 24;122(2):57-9. doi: 10.1016/s0025-7753(04)74140-8.

DOI:10.1016/s0025-7753(04)74140-8

PMID:14733856

Abstract

BACKGROUND AND OBJECTIVE

We aimed to compare treatment adherence and toxicity of isoniazide (H) (6 months) compared with rifampicine (R) + pirazinamide (Z) (2 months) in homeless patients in latent tuberculous infection (LTBI).

PATIENTS AND METHOD

Randomized and controlled prospective study.

RESULTS

We included 172 patients (116 males and 56 females) with an age average of 42.3 (12.8) years; 31 (18%) had recent conversion and 72 (41.8%) had some risk factor of hepatotoxicity. Both bivariate and multivariate analysis (p < 0.001; OR = 5.15 [2.34-11.35]) showed that the treatment was completed by 61.5% of patients administered the R+Z regimen, while it was completed only by 28.2% of those administered H for 6 months. Moreover, treatment was completed by 48.4% of Spanish or foreign patients with legal residence, while it was completed only by 28.6% of immigrant patients with no legal residence (p = 0.044 in bivariate analysis).

CONCLUSIONS

The R+Z regimen for 2 months as treatment of LTBI in homeless patients displays a higher adherence than H for 6 months. There were no differences in toxicity.

摘要

背景与目的

我们旨在比较异烟肼（H）（6个月）与利福平（R）+吡嗪酰胺（Z）（2个月）对潜伏性结核感染（LTBI）无家可归患者的治疗依从性和毒性。

患者与方法

随机对照前瞻性研究。

结果

我们纳入了172例患者（116例男性和56例女性），平均年龄42.3（12.8）岁；31例（18%）近期有结核菌阳转，72例（41.8%）有肝毒性危险因素。双变量和多变量分析均显示（p < 0.001；OR = 5.15 [2.34 - 11.35]），接受R+Z方案治疗的患者中有61.5%完成了治疗，而接受H治疗6个月的患者中仅有28.2%完成了治疗。此外，有合法居留身份的西班牙或外国患者中有48.4%完成了治疗，而无合法居留身份的移民患者中仅有28.6%完成了治疗（双变量分析中p = 0.044）。