Delayed Sputum Culture Conversion in Tuberculosis– Human Immunodeficiency Virus–Coinfected Patients With Low Isoniazid and Rifampicin Concentrations

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dc.contributor.authorSekaggya-Wiltshire, Christine
dc.contributor.authorBraun, Amrei von
dc.contributor.authorLamorde, Mohammed
dc.contributor.authorLedergerber, Bruno
dc.contributor.authorBuzibye, Allan
dc.contributor.authorHenning, Lars
dc.contributor.authorMusaazi, Joseph
dc.contributor.authorGutteck, Ursula
dc.contributor.authorDenti, Paolo
dc.contributor.authorKock, Miné de
dc.contributor.authorJetter, Alexander
dc.contributor.authorByakika-Kibwika, Pauline
dc.contributor.authorEberhard, Nadia
dc.contributor.authorMatovu, Joshua
dc.contributor.authorJoloba, Moses
dc.contributor.authorMuller, Daniel
dc.contributor.authorManabe, Yukari C.
dc.contributor.authorKamya, Moses R.
dc.contributor.authorCorti, Natascia
dc.contributor.authorKambugu, Andrew
dc.contributor.authorCastelnuovo, Barbara
dc.contributor.authorFehr2, Jan S.
dc.date.accessioned2022-01-12T09:49:24Z
dc.date.available2022-01-12T09:49:24Z
dc.date.issued2018
dc.description.abstractThe relationship between concentrations of antituberculosis drugs, sputum culture conversion, and treatment outcome remains unclear. We sought to determine the association between antituberculosis drug concentrations and sputum conversion among patients coinfected with tuberculosis and human immunodeficiency virus (HIV) and receiving first-line antituberculosis drugs. Methods. We enrolled HIV-infected Ugandans with pulmonary tuberculosis. Estimation of first-line antituberculosis drug concentrations was performed 1, 2, and 4 hours after drug intake at 2, 8, and 24 weeks of tuberculosis treatment. Serial sputum cultures were performed at each visit. Time-to-event analysis was used to determine factors associated with sputum culture conversion. Results. We enrolled 268 HIV-infected patients. Patients with low isoniazid and rifampicin concentrations were less likely to have sputum culture conversion before the end of tuberculosis treatment (hazard ratio, 0.54; 95% confidence interval, .37–.77; P = .001) or by the end of follow-up (0.61; .44–.85; P = .003). Patients in the highest quartile for area under the rifampicin and isoniazid concentration-time curves for were twice as likely to experience sputum conversion than those in the lowest quartile. Rifampicin and isoniazid concentrations below the thresholds and weight <55 kg were both risk factors for unfavorable tuberculosis treatment outcomes. Only 4.4% of the participants had treatment failure. Conclusion. Although low antituberculosis drug concentrations did not translate to a high proportion of patients with treatment failure, the association between low concentrations of rifampicin and isoniazid and delayed culture conversion may have implications for tuberculosis transmission.en_US
dc.identifier.citationSekaggya-Wiltshire, C., Von Braun, A., Lamorde, M., Ledergerber, B., Buzibye, A., Henning, L., ... & Fehr, J. S. (2018). Delayed Sputum Culture Conversion in Tuberculosis–Human Immunodeficiency Virus–Coinfected Patients With Low Isoniazid and Rifampicin Concentrations. Clinical Infectious Diseases, 67(5), 708-716. DOI: 10.1093/cid/ciy179en_US
dc.identifier.other10.1093/cid/ciy179
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/1210
dc.language.isoenen_US
dc.publisherClinical Infectious Diseasesen_US
dc.subjectTuberculosisen_US
dc.subjectOutcomesen_US
dc.subjectPharmacokineticsen_US
dc.subjectAnti-tuberculosis drugsen_US
dc.titleDelayed Sputum Culture Conversion in Tuberculosis– Human Immunodeficiency Virus–Coinfected Patients With Low Isoniazid and Rifampicin Concentrationsen_US
dc.typeArticleen_US
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