HIV-positive patients treated for multidrug-resistant tuberculosis: clinical outcomes in the HAART era

Int J Tuberc Lung Dis. 2012;16(3):348-54. doi: 10.5588/ijtld.11.0473.


Setting: Multidrug-resistant tuberculosis (MDR-TB) and the human immunodeficiency virus (HIV) pose two of the greatest threats to global tuberculosis (TB) control. Given expanding global access to antiretroviral therapy (ART) and second-line TB drugs, more data are needed on experiences treating MDR-TB and HIV co-infection in resource-poor settings.

Objective: To describe the clinical characteristics, management, outcomes, and factors associated with survival among HIV-positive individuals receiving treatment for MDR-TB.

Design: This was a retrospective case series of 52 HIV-positive individuals receiving treatment for MDR-TB in Lima, Peru. We used Cox proportional hazards regression models to identify risk factors for mortality.

Results: A total of 31 (57%) of the cohort died on treatment, with the majority of deaths due to MDR-TB. Low baseline weight predicted a three-fold increased rate of death (aHR 3.1, 95%CI 1.5-6.7), while individuals receiving highly active ART experienced a significantly lower rate of death compared to those who were not (aHR 0.4, 95%CI 0.2-0.9).

Conclusion: Early ART is likely a key component of effective MDR-TB management in co-infected individuals.

MeSH terms

  • Adult
  • Anti-HIV Agents / administration & dosage
  • Anti-HIV Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active / methods
  • Antitubercular Agents / supply & distribution
  • Antitubercular Agents / therapeutic use*
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology*
  • Health Services Accessibility*
  • Humans
  • Male
  • Peru / epidemiology
  • Proportional Hazards Models
  • Regression Analysis
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Tuberculosis, Multidrug-Resistant / complications
  • Tuberculosis, Multidrug-Resistant / drug therapy
  • Tuberculosis, Multidrug-Resistant / epidemiology*
  • Young Adult


  • Anti-HIV Agents
  • Antitubercular Agents