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Published on: September 5, 2017
Risk factors for recurrence of tuberculosis
Pedro Dornelles Picon1, Sergio Luiz Bassanesi, Maria Luiza Avancini Caramori
1Universidade Federal do Rio Grande do Sul - UFRGS, Federal University of Rio Grande do Sul - Porto Alegre (RS) Brazil. pedpicon@terra.com.br
Summary
Tuberculosis recurrence is significantly higher in HIV-positive patients and those noncompliant with treatment. Implementing post-treatment surveillance and supervised therapy can aid early detection and prevention of recurrent tuberculosis.
Area of Science:
- Infectious Diseases
- Public Health
- Epidemiology
Background:
- Tuberculosis (TB) remains a global health challenge.
- Identifying risk factors for TB recurrence is crucial for effective disease management.
- Previous studies have explored various factors, but robust data on specific risk groups are needed.
Purpose of the Study:
- To identify key risk factors associated with the recurrence of tuberculosis (TB) after successful treatment.
- To analyze the impact of human immunodeficiency virus (HIV) infection and treatment compliance on TB recurrence.
- To inform strategies for preventing and managing TB recurrence.
Main Methods:
- A cohort of 610 patients treated for active pulmonary tuberculosis between 1989-1994 using a rifampin, isoniazid, and pyrazinamide (RHZ) regimen was studied.
- Patients were monitored for recurrence for an average of 7.7 years using health department data.
- Statistical analyses included t-tests, chi-square/Fisher's exact tests, and Cox regression models to identify independent risk factors.
Main Results:
- A total of 26 cases (4.3%) of TB recurrence were observed, with a rate of 0.55 per 100 patient-years.
- HIV-positive patients exhibited a significantly higher recurrence rate (5.95/100 patient-years) compared to HIV-negative patients (0.48/100 patient-years).
- Multivariate analysis identified HIV infection (RR=8.04) and noncompliance with treatment (RR=6.43) as independent predictors of TB recurrence.
Conclusions:
- Recurrence of tuberculosis is significantly more frequent in patients with HIV co-infection and those who do not adhere to their prescribed treatment regimen.
- Patients with identified risk factors, such as HIV status or noncompliance, would benefit from enhanced post-treatment surveillance.
- Supervised treatment strategies may be beneficial in preventing noncompliance and reducing tuberculosis recurrence.
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