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Free Content Achieving international targets for tuberculosis treatment success among HIV-positive patients in New York City

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OBJECTIVE: To review outcomes of human immunodeficiency virus (HIV) positive tuberculosis (TB) patients in New York City (NYC) to determine if the World Health Organization treatment success target of 85% was met in a setting with ready access to treatment for HIV and TB.

DESIGN: Retrospective review of new TB patients diagnosed from 1995 to 2004, excluding patients with rifampin (RMP) resistance.

RESULTS: Of 9198 eligible TB patients, 83% had achieved treatment success, 8% died during treatment, 4% failed, 3% defaulted and 2% were transferred from NYC. Among 6374 HIV-negative individuals, treatment success was consistently over 85%; 5% died during treatment. Among 2824 HIV-positive individuals, treatment success was 72% overall and 66% in sputum acid-fast bacilli smear-positive patients. Mortality among the HIV-positive decreased from 26% in 1995 to 14% in 2004. HIV-positive patients achieved higher treatment success if 1) they received treatment by directly observed therapy (DOT) (82% vs. 74%, ORadj = 1.80, 95%CI 1.44–2.26), or 2) were administered rifabutin (RFB) in the regimen, a proxy for receiving antiretroviral therapy (ART) (84% vs. 78%, ORadj = 1.49, 95%CI 1.20–1.85). Treatment success of 85% was achieved in HIV-positive patients who received RFB and DOT.

CONCLUSION: High mortality precluded achieving 85% treatment success among HIV-positive TB patients. DOT and ART remain essential for improving success among co-infected patients everywhere.
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Keywords: HIV-TB co-infection; HIV/AIDS; drug therapy; treatment success; tuberculosis

Document Type: Regular Paper

Affiliations: 1: New York City Department of Health and Mental Hygiene, New York, New York, USA 2: New York City Department of Health and Mental Hygiene, New York, New York, USA; and Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Publication date: 2010-12-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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