Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Emerg Infect Dis. 2013 Mar;19(3):416-24. doi: 10.3201/eid1903.120998.
High mortality rates have been reported for patients co-infected with extensively drug-resistant tuberculosis (XDR-TB) and HIV, but treatment outcomes have not been reported. We report treatment outcomes for adult XDR TB patients in KwaZulu-Natal Province, South Africa. Initial data were obtained retrospectively, and outcomes were obtained prospectively during 24 months of treatment. A total of 114 XDR TB patients were treated (median 6 drugs, range 3-9 drugs); 82 (73%) were HIV positive and 50 (61%) were receiving antiretroviral therapy. After receiving treatment for 24 months, 48 (42%) of 114 patients died, 25 (22%) were cured or successfully completed treatment, 19 (17%) withdrew from the study, and 22 (19%) showed treatment failure. A higher number of deaths occurred among HIV-positive patients not receiving antiretroviral therapy and among patients who did not show sputum culture conversion. Culture conversion was a major predictor of survival but was poorly predictive (51%) of successful treatment outcome.
报告称，合并广泛耐药结核（XDR-TB）和 HIV 感染的患者死亡率较高，但尚未报告其治疗结局。我们报告了南非夸祖鲁-纳塔尔省 XDR-TB 成年患者的治疗结局。初始数据采用回顾性方法获得，治疗 24 个月期间采用前瞻性方法获得结局。共治疗了 114 例 XDR-TB 患者（中位数 6 种药物，范围 3-9 种药物）；82 例（73%）HIV 阳性，50 例（61%）接受抗逆转录病毒治疗。114 例患者接受 24 个月治疗后，48 例（42%）死亡，25 例（22%）治愈或成功完成治疗，19 例（17%）退出研究，22 例（19%）治疗失败。未接受抗逆转录病毒治疗的 HIV 阳性患者和未发生痰培养转换的患者中，死亡人数更多。培养转换是生存的主要预测因素，但对治疗结局成功的预测效果较差（51%）。
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