Tuberculosis Mortality (Corbett EL), Drug Resistance, and Infectiousness in Patients

with and without HIV infection in Peru

Introduction


Tuberculosis kills 1.7 million people each year. (Corbett EL, Watt CJ, Walker N,
Maher D, Williams BG, Raigilone MC, Dye C 2003) with proper treatment most
cases do not result in death. However, with a co-infection of HIV and multi-Drug
resistant tuberculosis (MDRTB) is where the study is trying to get answers about
the mortality. This study was conducted to provide much needed information that
would provide knowledge about early treatment to help reduce the mortality rate
The scientists did this research to try to figure out if early treatment would reduce
the chance of death. The importance of this study is to find a link between HIV and
MDRTB and if so, could there be a treatment. To find out the effects and mortality of
HIV and MDRTB in patients currently diagnosed with tuberculosis.

Materials and Methods

A study was conducted 287 patients, Sputum samples were obtained, HIV Antibody
testing, Sputum samples were obtained. At a hospital in Peru, 176 patients were
tested for the antibody of those tested 8 were positive . During the study, all patients
received the treatment and was observed, the laboratory results were immediately
told to the Doctors and the patients. All study participants received the standard
Peruvian treatment for tuberculosis. All study participants were also treated with a
follow up visit to determine ways of treatment and results from participating in the
study. Continuous variables were used to aid in providing the results that were
desired. As the treatment in Peru is much different than the United States patients
were treated with Peruvian treatments. Only 12 patients received the second line
drug due to the costs and availability of the second line drug.

Results

MDRTB diagnosed in 18%. Out of the patients in the study 71% of the people died.
HIV and MDRTB co-infected caused 55% of the deaths. Sputum smears and culture
samples were taken, of those most sputum did grow MDRTB and both cultures that
were obtained were positive throughout the follow up visits. After testing 12 of the
40 patients that were on treatment became negative on treatment, however 8 of
those 12 were not HIV positive. This is not the optimal results that were previously
hoped to be.

Discussion
This study not only increased the awareness of the co-infection, it also made a
significant difference on the survival of the patients that will acquire the co-infection
of HIV and Tuberculosis. HIV positive tuberculosis patients died during follow-up. A
rate that was much higher than expected. Most of the patients with MDRTB
continued to e infected during the treatment period, this is cause for concern
considering in countries that are less developed there is no way to isolate the
patients that are infected from the other patients in the hospital. As a result of the
study they are now testing for tuberculosis with sputum on the same day in patients
with respiratory symptoms.


Works Cited
Corbett EL, W. /. The growing burden of tuberculosis global trends and interactions
with the HIV epidemic. Arch Internal Med163: 1009-1021.