Krishnan Sonya, Gupte Nikhil, Paradkar Mandar, Gupte Akshay, Naik Mrunmayi, Raskar Swapnil, Suryavanshi Nishi, Pradhan Neeta, Gaikwad Sanjay, Karyakarte Rajesh, Lokhande Rahul, Luke Elizabeth Hanna, Thiruvengadam Kannan, Padmapriyadarsini Chandrasekaran, Sahasrabudhe Tushar, Barthwal Madhusudan, Kakrani ArjunLal, Viswanathan Vijay, Kornfeld Hardy, Gupta Amita, Golub Jonathan E, Mave Vidya
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Johns Hopkins Center for Infectious Diseases in India, Johns Hopkins India, Pune, India.
Front Tuberc. 2024;2. doi: 10.3389/ftubr.2024.1433975. Epub 2024 Jul 11.
Some individuals with drug-susceptible pulmonary tuberculosis (PTB) experience tuberculosis recurrence. To evaluate the incidence of and risk factors for recurrence following completion of antituberculosis therapy, we pooled data from three prospective observational Indian PTB cohorts with 1164 individuals ≥14 years old included in our analysis. Ninety-five (8%) experienced recurrence with an 8.5 cases/100 person-years recurrence incidence rate (95% confidence interval 6.9-10.3) and a median time to recurrence of 6 months. On multivariable logistic regression, month 2 culture positivity (aHR 2.06; 95% CI 1.17-3.63), BMI <17 mg/kg (aHR 1.7; 95% CI 1.1-2.8), and male sex (aHR 1.92; 95% CI 1.05-3.51) were independent recurrence risk factors. Understanding risk factors for TB recurrence could enable clinicians to identify patients at risk for recurrence during antituberculosis therapy and may be used to alter patient care strategies, such as more frequent monitoring post treatment for high-risk individuals.
一些药物敏感型肺结核(PTB)患者会出现结核病复发。为了评估抗结核治疗结束后复发的发生率及危险因素,我们汇总了来自印度三个前瞻性观察性PTB队列的数据,分析纳入了1164名年龄≥14岁的个体。95名(8%)患者出现复发,复发发生率为8.5例/100人年(95%置信区间6.9 - 10.3),复发的中位时间为6个月。多变量逻辑回归分析显示,治疗第2个月培养阳性(调整后风险比[aHR] 2.06;95%置信区间1.17 - 3.63)、体重指数(BMI)<17 mg/kg(aHR 1.7;95%置信区间1.1 - 2.8)以及男性(aHR 1.92;95%置信区间1.05 - 3.51)是独立的复发危险因素。了解结核病复发的危险因素可使临床医生在抗结核治疗期间识别有复发风险的患者,并可用于改变患者护理策略,例如对高危个体在治疗后进行更频繁的监测。