Sputum culture reversion in longer treatments with bedaquiline, delamanid, and repurposed drugs for drug-resistant tuberculosis
Kho S. Seung K.J. Huerga H. Bastard M. Khan P.Y. Mitnick C.D. Rich M.L. Islam S. Zhizhilashvili D. Yeghiazaryan L. Nikolenko E.N. Zarli K. Adnan S. Salahuddin N. Ahmed S. Vargas Z.H.R. Bekele A. Shaimerdenova A. Tamirat M. Gelin A. Vilbrun S.C. Hewison C. Khan U. Franke M.
December 2024Nature Research
Nature Communications
2024#15Issue 1
Sputum culture reversion after conversion is an indicator of tuberculosis (TB) treatment failure. We analyze data from the endTB multi-country prospective observational cohort (NCT03259269) to estimate the frequency (primary endpoint) among individuals receiving a longer (18-to-20 month) regimen for multidrug- or rifampicin-resistant (MDR/RR) TB who experienced culture conversion. We also conduct Cox proportional hazard regression analyses to identify factors associated with reversion, including comorbidities, previous treatment, cavitary disease at conversion, low body mass index (BMI) at conversion, time to conversion, and number of likely-effective drugs. Of 1,286 patients, 54 (4.2%) experienced reversion, a median of 173 days (97-306) after conversion. Cavitary disease, BMI < 18.5, hepatitis C, prior treatment with second-line drugs, and longer time to initial culture conversion were positively associated with reversion. Reversion was uncommon. Those with cavitary disease, low BMI, hepatitis C, prior treatment with second-line drugs, and in whom culture conversion is delayed may benefit from close monitoring following conversion.
Text of the article Перейти на текст статьи
Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA, United States
Partners in Health, 800 Boylston Street Suite 300, Boston, MA, United States
Epicentre, 14-34 Avenue Jean Jaurès, Paris, France
Department of Clinical Research, London School of Hygiene & amp; Tropical Medicine, London, United Kingdom
Interactive Research and Development Global, Singapore, Singapore
Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States
Interactive Research and Development, Dhaka, Bangladesh
Médecins sans Frontières, Tbilisi, Georgia
National Center for Pulmonology, Yerevan, Armenia
Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus
Médecins sans Frontières, Yangon, Myanmar
Indus Hospital and Health Network, Karachi, Pakistan
Interactive Research and Development, Karachi, Pakistan
Maria Auxiliadora Hospital, San Juan de Miraflores, Peru
Department of Internal Medicine, Tikur Anbessa Specialized Hospital and Addis Ababa University, College of Health Sciences, Addis Ababa, Ethiopia
Karaganda Regional Center of Phthisiopulmonology, Karaganda, Kazakhstan
Partners in Health, Lesotho, Maseru, Lesotho
Zanmi Lasante, Port-au-Prince, Haiti
Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), Port-au-Prince, Haiti
Medical Department, Médecins sans Frontières, Paris, France
Division of Global Health Equity
Partners in Health
Epicentre
Department of Clinical Research
Interactive Research and Development Global
Department of Global Health and Social Medicine
Interactive Research and Development
Médecins sans Frontières
National Center for Pulmonology
Republican Research and Practical Centre for Pulmonology and Tuberculosis
Médecins sans Frontières
Indus Hospital and Health Network
Interactive Research and Development
Maria Auxiliadora Hospital
Department of Internal Medicine
Karaganda Regional Center of Phthisiopulmonology
Partners in Health
Zanmi Lasante
Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO)
Medical Department
10 лет помогаем публиковать статьи Международный издатель
Книга Публикация научной статьи Волощук 2026 Book Publication of a scientific article 2026