Journal Article

Effects of Human Immunodeficiency Virus Infection on Recurrence of Tuberculosis after Rifampin-Based Treatment: An Analytical Review

Eline L. Korenromp, Fabio Scano, Brian G. Williams, Christopher Dye and Paul Nunn

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 37, issue 1, pages 101-112
Published in print July 2003 | ISSN: 1058-4838
Published online July 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/375220
Effects of Human Immunodeficiency Virus Infection on Recurrence of Tuberculosis after Rifampin-Based Treatment: An Analytical Review

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We reviewed 47 prospective studies of recurrence of pulmonary tuberculosis (TB) after cure to assess the influence of human immunodeficiency virus (HIV) infection and rifampin treatment. Multivariate regression revealed that the recurrence rate for HIV-uninfected persons increased with decreasing duration of therapy: it was 1.4 cases per 100 person-years for recipients of ⩾7 months of rifampin therapy and 2.0 and 4.0 cases per 100 person-years for recipients of 5–6 and 2–3 months of rifampin therapy, respectively (trend P =.00014), over a mean follow-up duration of 34 months, at a TB incidence of 250 cases per 100,000 person-years. Relative risks of recurrence associated with HIV infection at these 3 treatment durations were 2.2, 2.1, and 3.4, respectively, with a significant interaction between HIV infection status and treatment duration (P =.025). The recurrence rate increased with the background TB incidence (P =.048), and it decreased over time since completion of treatment in HIV-uninfected but not in HIV-infected patients (overall trend, P =.00008; difference by HIV infection status, P =.025). In countries where HIV infection is endemic, TB recurrence may be reduced by administration of rifampin-based treatment for at least 6 months, in accordance with World Health Organization recommendations.

Journal Article.  6718 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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