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Published on: April 9, 2012
Comparison of intermittent ethambutol with rifampicin-based regimens in HIV-infected adults with PTB, Kampala
A Okwera1, J L Johnson, H Luzze
1National Tuberculosis and Leprosy Programme, Kampala, Uganda-Case Western Reserve University Research Collaboration, Kampala, Uganda. a_okwera@mucwru.or.ug
Background:
The human immunodeficiency virus (HIV) is a key factor responsible for the high rates of tuberculosis (TB) in sub-Saharan Africa. Treatment of TB with rifampicin (R, RMP) containing short-course regimens is highly effective in HIV-infected adults. We conducted a study to compare the efficacy and safety of intermittent ethambutol (E, EMB) with two RMP-containing regimens to treat pulmonary TB in HIV-infected patients.
Setting:
National Tuberculosis Treatment Centre, Mulago Hospital, Kampala, Uganda.
Design:
This was a prospective cohort compared to two non-randomised control groups. The study group and the two control arms were treated with 2 months of isoniazid (H), RMP, pyrazinamide (Z) and EMB followed by 6 E3H3 for the study group and 4HR or 6HR for controls.
Results:
Between April 1993 and March 2000, 136 patients were enrolled in the 2EHRZ/E3H3 arm, 147 in the 2EHRZ/4HR arm and 266 in the 2EHRZ/6HR arm. The relapse rate was 18.2 per 100 person-years observation (PYO) for the study regimen compared to 9.7/100 PYO (P = 0.0063) and 4.8/100 PYO (P = 0.0001) in patients treated with 2 EHRZ/4HR or 2EHRZ/6HR, respectively.
Conclusion:
The 2EHRZ/6E3H3 regimen is safe and effective but has a significant risk of relapse.
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