Effectiveness of supervised, intermittent therapy for tuberculosis in HIV-infected patients

AIDS. 1994 Aug;8(8):1103-8. doi: 10.1097/00002030-199408000-00010.

Abstract

Objective: To evaluate the effectiveness of supervised therapy for tuberculosis (TB) in patients with HIV infection.

Design: Retrospective, chart review.

Patients: Patients with TB and HIV infection.

Setting: Urban, public TB clinic.

Main measures and results: A total of 107 patients with TB and HIV infection were studied. Most were men (78%), African American (91%), uninsured or on Medicaid (88%), and 67% were injecting drug users. TB was diagnosed before AIDS in 31% of subjects, at the time of AIDS in 32%, and after AIDS in 37%. Clinical features varied by stage of HIV disease. Sixteen patients received no therapy and died before TB was diagnosed, 10 died during the first 8 weeks of treatment. Seventy-eight patients received > 8 weeks therapy, of whom 48 (62%) were given directly observed therapy twice weekly and 30 (38%) received self-administered daily therapy. Patients who received directly observed therapy were more likely to complete 6 months of therapy (96 versus 76%, P = 0.02) and more likely to survive after therapy ended (85 versus 57%, P = 0.01). By logistic regression, directly observed therapy, AIDS diagnosed before TB, and age were significantly associated with survival outcome.

Conclusion: Directly observed therapy for TB in patients with HIV infection is highly effective and associated with better adherence to therapy and survival.

Publication types

  • Comparative Study

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy*
  • AIDS-Related Opportunistic Infections / mortality
  • Acquired Immunodeficiency Syndrome / epidemiology
  • Acquired Immunodeficiency Syndrome / mortality
  • Adult
  • African Americans
  • Age Factors
  • Antitubercular Agents / therapeutic use
  • CD4 Lymphocyte Count
  • European Continental Ancestry Group
  • Female
  • HIV Seropositivity / epidemiology
  • Humans
  • Male
  • Medicaid
  • Medically Uninsured
  • Probability
  • Retrospective Studies
  • Risk Factors
  • Substance Abuse, Intravenous
  • Survival Rate
  • Treatment Outcome
  • Tuberculosis / drug therapy*
  • Tuberculosis / mortality
  • United States

Substances

  • Antitubercular Agents