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Weight gain and response to treatment for multidrug-resistant tuberculosis
Ma Tarcela Gler1, Ruffy Guilatco, Janice C Caoili
1Tropical Disease Foundation, Makati City, Philippines; Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia; Tuberculosis Research Unit, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Abstract:
Alternatives to culture are needed in high burden countries to assess whether response to treatment of multidrug-resistant-tuberculosis (MDR-TB) is satisfactory. The objective was to assess the association of weight gain and treatment outcome. The methods included analysis of clinical, bacteriologic, and weight from 439 MDR-TB patients in the Philippines. Odds ratios (ORs) were calculated to determine whether 5% weight gain during the first 6 months of treatment was associated with outcome. Three hundred and ten (71%) patients were cured and 129 (29%) had poor outcomes (death, defaulted, or failed treatment). Fifty-three percent were underweight (body mass index [BMI] < 18.5 kg/m(2)) before treatment. Five percent weight gain after completing 3 months of treatment was associated with good outcome among patients who were underweight before treatment (OR 2.1; 95% confidence interval [CI], 1.05 to 4.4). Baseline weight and degree of weight change during the first 6 months of treatment can help identify persons who are more likely to have poor outcomes and require other interventions.
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