n CME : Your SA Journal of CPD - Into the great unknown - treating drug-resistant TB and HIV : more about...HIV/TB

Volume 29, Issue 10
  • ISSN : 0256-2170



Reported treatment outcomes of multidrug-resistant tuberculosis (MDR-TB) are very variable. In a large meta-analysis, including studies that used second-line drugs in individualised or standardised protocols for MDR-TB, the overall treatment success estimate, defined as the proportion of patients who were cured or completed treatment, was 62% (95% CI 58 - 67%) and 11% of the patienst died. But the data on HIV status were not consistently reported. The initial outcomes reported for extensively drug-resistant tuberculosis (XDR-TB) from the Tugela Ferry outbreak showed a very high mortality rate of 98% (52/53 cases), all of whom were HIV-infected but in a 2009 case series of 60 XDR-TB patients 43 (72%) were HIV-positive. During follow-up 12/60 (20%) experienced sputum culture conversion, while 25/60 (42%) patients died.

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