Rifampin monoresistant tuberculosis and HIV comorbidity in California, 1993-2008: a retrospective cohort study.
Rifampin monoresistant tuberculosis and HIV comorbidity in California, 1993-2008: a retrospective cohort study.
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DOI：
10.1097/01.aids.0000432445.07437.07
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发表时间：
2013-10-23
期刊：
影响因子：
--
通讯作者：
Metcalfe JZ
中科院分区：
文献类型：
--
作者：
Prach LM;Pascopella L;Barry PM;Flood J;Porco TC;Hopewell PC;Metcalfe JZ
由于快速分子检测的扩大，利福平单药结核病（RMR-TB）越来越多地被发现。RMR-TB、耐多药结核病（MDR-TB）和艾滋病毒/艾滋病的纵向关联尚未得到完整描述。我们研究了加州16年间（1993-2008）RMR-TB、异烟肼单耐药TB （IMR-TB）、MDR-TB和药敏TB患者的临床特征和治疗结果。结核病病例与国家艾滋病毒/艾滋病登记处交叉匹配，艾滋病毒流行率分母使用非参数反向计算建模。在42582例结核病例中，分别有178例（0.4%）、3469例（8.1%）、635例（1.5%）为中度耐药结核、中度耐药结核和耐多药结核。从HAART前（1993-1996年）到HAART（2005-2008年）时期，艾滋病毒感染患者的RMR-TB率迅速下降（12.0比0.5 / 10万）。利福平耐药患者的比例从31%（95%可信区间为26%-38%）下降到11%（95%可信区间为5%-19%）。在控制HIV合并感染和其他协变量的多变量分析中，RMR-TB患者的死亡率是药物敏感性TB患者的两倍（RR 1.94, 95% CI 1.40-2.69）。随着加利福尼亚结核控制和艾滋病毒控制的改善，rmr结核/艾滋病毒率随着时间的推移大幅下降。RMR-TB患者的死亡率很高，即使在调整艾滋病毒状态后也是如此。
Rifampin mono-resistant tuberculosis (RMR-TB) is increasingly identified due to scale-up of rapid molecular tests. The longitudinal association of RMR-TB, multidrug-resistant TB (MDR-TB), and HIV/AIDS is incompletely described. We examined clinical characteristics and treatment outcomes of patients with RMR-TB, isoniazid mono-resistant TB (IMR-TB), MDR-TB, and drug-susceptible TB during a sixteen year period (1993–2008) in California. TB cases were cross-matched with the state HIV/AIDS registry, and HIV prevalence denominators modeled using non-parametric backcalculation. Of 42,582 TB cases, 178 (0.4%), 3,469 (8.1%), 635 (1.5%) were RMR-TB, IMR-TB, and MDR-TB, respectively. From the pre-HAART (1993–1996) to HAART (2005–2008) era, RMR-TB rates declined rapidly (12.0 vs. 0.5 per 100,000) among patients with HIV infection. The proportion of patients for whom rifampin resistance indicated RMR-TB (rather than MDR-TB) decreased from 31% (95% CI 26%–38%) to 11% (95% CI 5%–19%). In multivariate analysis controlling for HIV co-infection and other covariates, patients with RMR-TB were twice as likely to die as patients with drug sensitive TB (RR 1.94, 95% CI 1.40–2.69). RMR-TB/HIV rates declined substantially over time in association with improved TB control and HIV control in California. Mortality among patients with RMR-TB was high, even after adjusting for HIV status.
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影响因子：
3.7
作者：
Pascopella L;Deriemer K;Watt JP;Flood JM
通讯作者：
Flood JM
影响因子：
30.8
作者：
Comas, Inaki;Borrell, Sonia;Roetzer, Andreas;Rose, Graham;Malla, Bijaya;Kato-Maeda, Midori;Galagan, James;Niemann, Stefan;Gagneux, Sebastien
通讯作者：
Gagneux, Sebastien
影响因子：
120.7
作者：
CHAULK, CP;MOORERICE, K;CHAISSON, RE
通讯作者：
CHAISSON, RE
影响因子：
6.4
作者：
Bifani, Pablo;Mathema, Barun;Kreiswirth, Barry N.
通讯作者：
Kreiswirth, Barry N.
DOI：
10.1164/rccm.200503-417oc
发表时间：
2006-02-01
影响因子：
24.7
作者：
Burman, W;Benator, D;El-Sadr, W
通讯作者：
El-Sadr, W