The impact of isoniazid resistance on the treatment outcomes of smear positive re-treatment tuberculosis patients in the state of Andhra Pradesh, India.

<h4>Background</h4>Multi drug resistant and rifampicin resistant TB patients in India are treated with the World Health Organization (WHO) recommended standardized treatment regimens but no guidelines are available for the management of isoniazid (INH) resistant TB patients. There have b...

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Autores principales:	Dorai Deepa, Shanta Achanta, Jyoti Jaju, Koteswara Rao, Rani Samyukta, Mareli Claassens, Ajay M V Kumar, Vishnu Ph
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/63ac91ec644c460b847aabb5abe8a3ca
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spelling	oai:doaj.org-article:63ac91ec644c460b847aabb5abe8a3ca2021-11-18T08:51:28ZThe impact of isoniazid resistance on the treatment outcomes of smear positive re-treatment tuberculosis patients in the state of Andhra Pradesh, India.1932-620310.1371/journal.pone.0076189https://doaj.org/article/63ac91ec644c460b847aabb5abe8a3ca2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24146839/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Multi drug resistant and rifampicin resistant TB patients in India are treated with the World Health Organization (WHO) recommended standardized treatment regimens but no guidelines are available for the management of isoniazid (INH) resistant TB patients. There have been concerns that the standard eight-month retreatment regimen being used in India (2H3R3Z3E3S3/1H3R3Z3E3/5H3R3E3; H-Isoniazid; R-Rifampicin; Z-Pyrazinamide; E-Ethambutol; S-Streptomycin) may be inadequate to treat INH resistant TB cases and leads to poor treatment outcomes. We aimed to assess if INH resistance is associated with unfavorable treatment outcomes (death, default, failure and transferred out) among a cohort of smear positive retreatment TB patients registered in three districts of Andhra Pradesh, India.<h4>Methods</h4>We conducted a retrospective record review of all smear positive retreatment TB patients without rifampicin resistance registered during April-December 2011.<h4>Results</h4>Of 1,947 TB patients, 1,127 (58%) were tested with LPA-50 (4%) were rifampicin resistant, 933 (84%) were sensitive to INH and rifampicin and 144 (12%) were INH resistant. Of 144 INH resistant cases, 64 (44%) had poor treatment outcomes (25 (17%) default, 22 (15%) death, 12 (8%) failure and 5 (3%) transfer out) as compared to 287 (31%) among INH sensitive cases [aRR 1.46; 95%CI (1.19-1.78)].<h4>Conclusion</h4>Our study confirms that INH resistance is independently associated with unfavorable treatment outcomes among smear positive retreatment TB patients, indicating that the current treatment regimen may be inadequate. These findings call for an urgent need for randomized controlled trials to discover the most effective treatment regimen for managing INH resistant TB.Dorai DeepaShanta AchantaJyoti JajuKoteswara RaoRani SamyuktaMareli ClaassensAjay M V KumarVishnu PhPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 10, p e76189 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Dorai Deepa Shanta Achanta Jyoti Jaju Koteswara Rao Rani Samyukta Mareli Claassens Ajay M V Kumar Vishnu Ph The impact of isoniazid resistance on the treatment outcomes of smear positive re-treatment tuberculosis patients in the state of Andhra Pradesh, India.
description	<h4>Background</h4>Multi drug resistant and rifampicin resistant TB patients in India are treated with the World Health Organization (WHO) recommended standardized treatment regimens but no guidelines are available for the management of isoniazid (INH) resistant TB patients. There have been concerns that the standard eight-month retreatment regimen being used in India (2H3R3Z3E3S3/1H3R3Z3E3/5H3R3E3; H-Isoniazid; R-Rifampicin; Z-Pyrazinamide; E-Ethambutol; S-Streptomycin) may be inadequate to treat INH resistant TB cases and leads to poor treatment outcomes. We aimed to assess if INH resistance is associated with unfavorable treatment outcomes (death, default, failure and transferred out) among a cohort of smear positive retreatment TB patients registered in three districts of Andhra Pradesh, India.<h4>Methods</h4>We conducted a retrospective record review of all smear positive retreatment TB patients without rifampicin resistance registered during April-December 2011.<h4>Results</h4>Of 1,947 TB patients, 1,127 (58%) were tested with LPA-50 (4%) were rifampicin resistant, 933 (84%) were sensitive to INH and rifampicin and 144 (12%) were INH resistant. Of 144 INH resistant cases, 64 (44%) had poor treatment outcomes (25 (17%) default, 22 (15%) death, 12 (8%) failure and 5 (3%) transfer out) as compared to 287 (31%) among INH sensitive cases [aRR 1.46; 95%CI (1.19-1.78)].<h4>Conclusion</h4>Our study confirms that INH resistance is independently associated with unfavorable treatment outcomes among smear positive retreatment TB patients, indicating that the current treatment regimen may be inadequate. These findings call for an urgent need for randomized controlled trials to discover the most effective treatment regimen for managing INH resistant TB.
format	article
author	Dorai Deepa Shanta Achanta Jyoti Jaju Koteswara Rao Rani Samyukta Mareli Claassens Ajay M V Kumar Vishnu Ph
author_facet	Dorai Deepa Shanta Achanta Jyoti Jaju Koteswara Rao Rani Samyukta Mareli Claassens Ajay M V Kumar Vishnu Ph
author_sort	Dorai Deepa
title	The impact of isoniazid resistance on the treatment outcomes of smear positive re-treatment tuberculosis patients in the state of Andhra Pradesh, India.
title_short	The impact of isoniazid resistance on the treatment outcomes of smear positive re-treatment tuberculosis patients in the state of Andhra Pradesh, India.
title_full	The impact of isoniazid resistance on the treatment outcomes of smear positive re-treatment tuberculosis patients in the state of Andhra Pradesh, India.
title_fullStr	The impact of isoniazid resistance on the treatment outcomes of smear positive re-treatment tuberculosis patients in the state of Andhra Pradesh, India.
title_full_unstemmed	The impact of isoniazid resistance on the treatment outcomes of smear positive re-treatment tuberculosis patients in the state of Andhra Pradesh, India.
title_sort	impact of isoniazid resistance on the treatment outcomes of smear positive re-treatment tuberculosis patients in the state of andhra pradesh, india.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/63ac91ec644c460b847aabb5abe8a3ca
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The impact of isoniazid resistance on the treatment outcomes of smear positive re-treatment tuberculosis patients in the state of Andhra Pradesh, India.

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