Hernandez-Morfin N, Cohn S, Waja Z, Chaisson R E, Martinson N, Salazar-Austin N
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Public Health Action. 2025 Mar 1;15(1):33-37. doi: 10.5588/pha.24.0051. eCollection 2025 Mar.
Limited data exist on TB treatment outcomes among pregnant women with TB. Physiological and immunological adaptations during pregnancy may affect the efficacy of TB treatment. We aimed to evaluate factors associated with unsuccessful TB treatment outcomes among pregnant women living with HIV (PWLHIV) and diagnosed with TB in the Tshepiso study.
In this secondary analysis, we used multivariable logistic regression to evaluate factors associated with unsuccessful TB treatment outcomes among PWLHIV with drug-sensitive TB disease enrolled in the Tshepiso study in Soweto, South Africa, from 2011-2014.
This analysis includes 79 PWLHIV diagnosed with drug-sensitive TB during pregnancy; 18 (23%) had an unsuccessful treatment outcome. Factors associated with unsuccessful TB treatment include detectable HIV RNA viral load at enrollment to the study (aOR 5.1, 95% CI 1.1-25.3), presence of extrapulmonary TB (aOR 2.2, 95% CI 0.4-11.7), bacteriological (positive smear and/or culture) confirmation of TB (aOR 2.1, 95% CI 0.7-6.7), and anemia (Hb ≤ 10.5 g/dL) (aOR 1.0, 95% CI 0.3-3.1). The only factor with statistical significance was a detectable HIV RNA viral load.
Detectable HIV viral load emerges as a critical factor associated with an unsuccessful TB treatment outcome in pregnant women living with HIV and diagnosed with TB.
关于患结核病的孕妇的结核病治疗结果的数据有限。孕期的生理和免疫适应可能会影响结核病治疗的疗效。在Tshepiso研究中，我们旨在评估与感染艾滋病毒的孕妇（PWLHIV）且被诊断为结核病的结核病治疗结果未成功相关的因素。
在这项二次分析中，我们使用多变量逻辑回归来评估2011年至2014年在南非索韦托参加Tshepiso研究的患有药物敏感型结核病的PWLHIV中与结核病治疗结果未成功相关的因素。
该分析包括79名在孕期被诊断为药物敏感型结核病的PWLHIV；18名（23%）治疗结果未成功。与结核病治疗结果未成功相关的因素包括研究入组时可检测到的艾滋病毒RNA病毒载量（调整后比值比5.1，95%置信区间1.1 - 25.3）、肺外结核病的存在（调整后比值比2.2，95%置信区间0.4 - 11.7）、结核病的细菌学（涂片阳性和/或培养阳性）确认（调整后比值比2.1，95%置信区间0.7 - 6.7）和贫血（血红蛋白≤10.5 g/dL）（调整后比值比1.0，95%置信区间0.3 - 3.1）。唯一具有统计学意义的因素是可检测到的艾滋病毒RNA病毒载量。
可检测到的艾滋病毒病毒载量是与感染艾滋病毒且被诊断为结核病的孕妇结核病治疗结果未成功相关的关键因素。
