Time To Culture Conversion And Outcomes In HIV-positive Multidrug-resistant TB Patients Treated With Regimens Containing Moxifloxacin Or Ofloxacin
Collaborator: C Reddy, Field Epidemiology Training Programme, NICD, Johannesburg, South Africa
Multidrug-resistant TB (MDR-TB) is associated with poor treatment outcomes among HIV-infected persons. A record review was conducted of HIV-positive, MDR-TB patients on ART at Sizwe Tropical Diseases Hospital, Johannesburg between 2007 and 2012, to compare culture conversion and outcomes in patients on regimens containing either ofloxacin or moxifloxacin. The review involved a descriptive analysis for socio-demographic factors; log-rank test for comparing time to sputum conversion; multivariable Cox regression for factors associated with time to culture conversion; and Chi-square test for association between regimens and treatment outcomes. Of 758 eligible patients, 405 received moxifloxacin and 353 received ofloxacin. Time to sputum culture conversion was not significantly different between treatment groups (HR=0.97; p=0.734) while the cure rate of 30% (n=122) was significantly better in the moxifloxacin group compared to 19% (n=67) in the ofloxacin group (p=0.001). South Africa should continue the use of moxifloxacin-containing regimens, paying special attention to individualised weight-based dosing. Additionally, interventions aimed at early diagnosis and treatment of HIV-positive, MDR-TB cases are essential to improve outcomes.