在坎帕拉，对感染艾滋病毒的成年肺结核患者间歇性乙胺丁醇与基于利福平的治疗方案的比较。
Comparison of intermittent ethambutol with rifampicin-based regimens in HIV-infected adults with PTB, Kampala.
作者信息
Okwera A, Johnson J L, Luzze H, Nsubuga P, Kayanja H, Cohn D L, Nunn P, Ellner J J, Whalen C C, Mugerwa R D
机构信息
National Tuberculosis and Leprosy Programme, Kampala, Uganda-Case Western Reserve University Research Collaboration, Kampala, Uganda.
出版信息
Int J Tuberc Lung Dis. 2006 Jan;10(1):39-44.
BACKGROUND
The human immunodeficiency virus (HIV) is a key factor responsible for the high rates of tuberculosis (TB) in sub-Saharan Africa. Treatment of TB with rifampicin (R, RMP) containing short-course regimens is highly effective in HIV-infected adults. We conducted a study to compare the efficacy and safety of intermittent ethambutol (E, EMB) with two RMP-containing regimens to treat pulmonary TB in HIV-infected patients.
SETTING
National Tuberculosis Treatment Centre, Mulago Hospital, Kampala, Uganda.
DESIGN
This was a prospective cohort compared to two non-randomised control groups. The study group and the two control arms were treated with 2 months of isoniazid (H), RMP, pyrazinamide (Z) and EMB followed by 6 E3H3 for the study group and 4HR or 6HR for controls.
RESULTS
Between April 1993 and March 2000, 136 patients were enrolled in the 2EHRZ/E3H3 arm, 147 in the 2EHRZ/4HR arm and 266 in the 2EHRZ/6HR arm. The relapse rate was 18.2 per 100 person-years observation (PYO) for the study regimen compared to 9.7/100 PYO (P = 0.0063) and 4.8/100 PYO (P = 0.0001) in patients treated with 2 EHRZ/4HR or 2EHRZ/6HR, respectively.
CONCLUSION
The 2EHRZ/6E3H3 regimen is safe and effective but has a significant risk of relapse.
背景
人类免疫缺陷病毒（HIV）是撒哈拉以南非洲地区结核病（TB）高发病率的关键因素。含利福平（R，RMP）的短程方案治疗HIV感染成人的结核病非常有效。我们开展了一项研究，比较间歇性乙胺丁醇（E，EMB）与两种含RMP方案治疗HIV感染患者肺结核的疗效和安全性。
地点
乌干达坎帕拉穆拉戈医院国家结核病治疗中心。
设计
这是一项前瞻性队列研究，与两个非随机对照组进行比较。研究组和两个对照组均接受2个月的异烟肼（H）、RMP、吡嗪酰胺（Z）和EMB治疗，随后研究组接受6个月的E3H3治疗，对照组分别接受4个月的HR或6个月的HR治疗。
结果
1993年4月至2000年3月期间，2EHRZ/E3H3组纳入136例患者，2EHRZ/4HR组纳入147例患者，2EHRZ/6HR组纳入266例患者。研究方案的复发率为每100人年观察期（PYO）18.2例，而接受2EHRZ/4HR或2EHRZ/6HR治疗的患者复发率分别为9.7/100 PYO（P = 0.0063）和4.8/100 PYO（P = 0.0001）。
结论
2EHRZ/6E3H3方案安全有效，但有显著的复发风险。
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