Prognostic factors for treatment success in patients with multidrug-resistant tuberculosis in China

• Published in: The international journal of tuberculosis and lung disease Vol. 22; no. 3; pp. 300 - 305
• Main Authors: Fan, Y-M., Ding, S-P., Bao, Z-J., Wu, L-M., Zhen, L-B., Xia, Q., Zhu, M.
• Format: Journal Article
• Language: English
• Published: France International Union Against Tuberculosis and Lung Disease 01.03.2018; International Union against Tuberculosis and Lung Disease (IUATLD)
• Subjects: Bilirubin; Blood; Cycloserine; Demographics; Follow-Up; Hemoglobin; Initial Treatment; Leukocytes; Mdr-Tb; Multidrug resistance; Multidrug resistant organisms; Occupations; Patients; Salicylic acid; Smoking; Standard Regimens; Success; Thyroid; Thyroid-stimulating hormone; Treatment Success; Tuberculosis; Uric acid; Urine; China
• ISSN: 1027-3719; 1815-7920
• DOI: 10.5588/ijtld.17.0183

OBJECTIVE: To examine the clinical outcomes and associated prognostic factors among patients with multidrug-resistant tuberculosis (MDR-TB) in China.METHODS: This retrospective study involved 243 patients with MDR-TB. All patients received standard regimens containing para-amino salicylic acid (PAS) and/or cycloserine (CS). The demographic, social and clinical characteristics of patients were recorded and the patients were followed up for 24 months.RESULTS: Treatment success was closely associated with young age, non-farming occupations, shorter history or smoking, normal urine results, initial MDR-TB treatment regimen, increased haemoglobin, direct bilirubin, uric acid and thyroid stimulating hormone (TSH) levels, and lower white blood cell, neutrophil and blood platelet counts (all P < 0.05). On multivariable analysis, increased haemoglobin (hazard ratio [HR] 1.019, 95%CI 1.007-1.032, P = 0.002) and TSH levels (HR 1.002, 95%CI 1.006-1.039, P = 0.008), normal urine results (HR 1.541, 95%CI 1.008-2.358, P = 0.046) and initial MDR-TB treatment regimen (HR 2.238, 95%CI 1.090-4.597, P = 0.028) were prognostic factors for treatment success in MDR-TB.CONCLUSIONS: Higher haemoglobin and TSH levels, normal urine results and initial MDR-TB treatment regimen might predict successful treatment of MDR-TB.