Cathy Connolly|Alasdair Reid|Gerry Davies|W Sturm|Keith P. W. J. McAdam|David Wilkinson
Relapse and mortality among HIV-infected and uninfected patients with tuberculosis successfully treated with twice weekly directly observed therapy in rural South Africa
World Health Organization|South African Medical Research Council|World Health Organization|South African Medical Research Council|World Health Organization|South African Medical Research Council|World Health Organization|South African Medical Research Council|World Health Organization|South African Medical Research Council|South African Medical Research Council|World Health Organization|University of South Australia
objective determine posttreatment relapse mortality rates among hivinfected uninfected patients tuberculosis treated twiceweekly drug regimen direct observation dot setting hlabisa south africa patients group 403 patients tuberculosis 53 hiv infected cured following treatment isoniazid h rifampicin r pyrazinamide z ethambutol e given hospital median 17 days followed hrze twice weekly 2 months hr twice weekly 6 months community dot methods relapses identified hospital readmission 6monthly home visits relapse culture mycobacterium tuberculosis mortality given rates per 100 personyears observation pyo stratified hiv status history previous tuberculosis treatment results mean sd posttreatment followup 12 04 years total pyo499 78 patients 19 left area 58 14 died 248 62 remained well 19 5 relapsed relapse rates hivinfected uninfected patients 39 95 confidence interval ci 1563 36 95 ci 1161 per 100 pyo p07 probability relapse 18 months estimated 5 group mortality fourfold higher among hivinfected patients 178 44 deaths per 100 pyo hivinfected uninfected patients respectively p00001 probability survival 24 months estimated 59 81 respectively observed increase relapse mortality among previously treated patients compared new patients positive smear 2 months predict relapse mortality conclusion relapse rates acceptably low following successful dot twice weekly rifampicincontaining regimen irrespective hiv status previous treatment history mortality substantially increased among hivinfected patients even following successful dot requires attention