Montalvo Raúl, Bernabe-Ortiz Antonio, Kirwan Daniela E, Gilman Robert H
Universidad Continental, Huancayo Perú.
Servicio de Enfermedades Infecciosas y Tropicales, Hospital Daniel Alcides Carrión, Huancayo, Perú.
Afr J Infect Dis. 2018 Jun 18;12(2):47-54. doi: 10.21010/ajid.v12i2.8. eCollection 2018.
The changes in body composition markers (weight, fat mass, lean mass, and BMI) over time can be associated with TB treatment outcome among HIV-infected patients. The aim of this study was to investigate whether changes in fat mass and lean mass were associated with the treatment response among patients with HIV infection and pulmonary tuberculosis.
This was a prospective cohort study. Data from HIV-infected patients commencing TB therapy were analyzed. This included body weight measurement using bioimpedance equipment at baseline, one month, and two months after starting TB treatment.
The study was conducted in 125 patients, 17 patients (13.6%) died during treatment, of which 5 died during the first month of treatment, 4 during the second month and 8 after the second month. The group of patients with good response, increased their weight by 1.3 kg (p <0.001) at the end of the first month of TB treatment and 2.6 kg in the second month (p <0.001), and body fat increase was 1.2 Kg (p <0.001) and 2.3 kg (p <0.001), the first and second month respectively. The group of patients who died had lost 2.1 kg fat mass after the first month (p <0.001) and 3.7 kg in the second month (p <0.001).
Our results show that the weight change during TB treatment (increased fat mass) helps us predict therapeutic response. Weight loss during the first month of starting therapy should be evaluated thoroughly to identify the probable cause of treatment failure.
随着时间推移,身体成分指标(体重、脂肪量、瘦体重和体重指数)的变化可能与HIV感染患者的结核病治疗结果相关。本研究的目的是调查脂肪量和瘦体重的变化是否与HIV感染合并肺结核患者的治疗反应相关。
这是一项前瞻性队列研究。对开始结核病治疗的HIV感染患者的数据进行了分析。这包括在开始结核病治疗的基线、第1个月和第2个月使用生物电阻抗设备测量体重。
该研究共纳入125例患者,17例患者(13.6%)在治疗期间死亡,其中5例在治疗的第一个月死亡,4例在第二个月死亡,8例在第二个月后死亡。治疗反应良好的患者组在结核病治疗第一个月末体重增加了1.3千克(p<0.001),第二个月增加了2.6千克(p<0.001),第一个月和第二个月的体脂肪分别增加了1.2千克(p<0.001)和2.3千克(p<0.001)。死亡患者组在第一个月后脂肪量减少了2.1千克(p<0.001),第二个月减少了3.7千克(p<0.001)。
我们的结果表明,结核病治疗期间的体重变化(脂肪量增加)有助于我们预测治疗反应。开始治疗的第一个月体重减轻应进行全面评估,以确定治疗失败的可能原因。