Predictors of unfavourable treatment outcomes for HIV-associated MDR-TB in patients with viral hepatitis C

Abstract

The aim of study – to identify predictors of unfavorable outcomes in patients with co-morbidities of multidrug-resistant tuberculosis (MDR-TB); HIV infection; and viral hepatitis C (HCV) to optimize care.Materials and Methods. A total of 132 patients with MDRTB/HIV/HCV triple infection were included in the study: 112 individuals with favorable outcomes and 20 patients with unfavorable outcomes. To assess predictors of unfavorable outcomes; odds ratios and 95% confidence intervals were calculated. 95% confidence interval were calculated; and a prognostic model was built using logistic regression.Results. Generalization tuberculosis process increased the chance of unfavorable outcome by 8.13 times (95% CI: 2.252 – 29.354; p<0.001); treatment with chemotherapy regimens without the inclusion of the new highly effective antituberculosis drugs – 5.333 times (95% CI: 0.059 – 0.597; p=0.002); undesirable adverse drug reactions – 4.263 times (95% CI: 0.938 to 19.370; p=0.044); severe adverse drug reactions – 6.429 times (95% CI: 1.889 – 21.878; p=0.001); level of CD4-lymphocyte count less than 50 cells/µL – 7 times (95% CI: 2.180 – 22.482; p<0.001); stage 4B HIV infection – 4.1 times (95% CI: 1.527 – 11.007; p=0.003).Conclusion. The results obtained indicate the need to further study the problem of HIV-associated MDR-TB in combination with HCV in order to develop evidence-based algorithms for the management of this category of patients; taking into account the identified predictors of unfavorable treatment outcomes.