Table 3:
Associations between use of individual tuberculosis drugs and death among the HIV-positive population with multidrug-resistant tuberculosis
| aOR (95% CI) for all HIV-positive patients |
aOR (95% CI) for HIV-positive patients on ART* |
aOR (95% CI) for HIV-positive patients not known to be on ART*† |
|
|---|---|---|---|
| Number of effective Group A drugs used‡ | |||
| 0 | 1 (ref) | 1 (ref) | 1 (ref) |
| 1 | 0·53 (0·37–0·74) | 0·50 (0·36–0·71) | 0·70 (0·32–1·52) |
| 2 or more | 0·26 (0·18–0·38) | 0·26 (0·18–0·38) | 0·22 (0·05–0·98) |
| Number of effective Group B and C drugs used‡ | |||
| 0–1 | 1 (ref) | 1 (ref) | 1 (ref) |
| 2–3 | 0·87 (0·65–1·15) | 0·88 (0·64–1·20) | 0·67 (0·30–1·51) |
| 4 or more | 0·72 (0·46–1·12) | 0·74 (0·46–1·21) | 0·52 (0·21–1·29) |
| Moxifloxacin or levofloxacin use§ | |||
| Not used or used but resistant | 1 (ref) | 1 (ref) | 1 (ref) |
| Used and sensitive | 0·58 (0·45–0·75) | 0·59 (0·45–0·77) | 0·60 (0·27–1·33) |
| Bedaquiline and linezolid use§ | |||
| Neither used | 1 (ref) | 1 (ref) | 1 (ref) |
| Used linezolid but not bedaquiline | 0·87 (0·44–1·70) | 0·95 (0·50–1·79) | NA¶ |
| Used bedaquiline but not linezolid | 0·53 (0·38–0·74) | 0·55 (0·40–0·77) | 0·21 (0·04–1·23) |
| Used both linezolid and bedaquiline | 0·34 (0·25–0·46) | 0·34 (0·23–0·46) | 0·46 (0·09–2·45) |
All estimates from random effect models, binomial family, and adjusted for age, sex, site, year, past tuberculosis treatment, use of directly observed therapy, pre-treatment acid-fast bacilli smear status, World Bank income classification of country where study was done, and ART use. Group A drugs are bedaquiline, moxifloxacin, levofloxacin, and linezolid. Group B drugs are clofazimine, cycloserine, or terizidone. Group C drugs are ethambutol, pyrazinamide, delamanid, amikacin-streptomycin, ethionamide-protionamide, and para-aminosalicylic acid. ART=antiretroviral therapy. aOR=adjusted odds ratio. NA=not applicable.
The same models were used, but there was no adjustment for ART use, because the HIV population was stratified by the use or not of ART therapy.
This includes 183 patients with unknown ART status.
Estimates for number of effective drugs in Group A or Groups B and C adjusted for each other in the same model. Use of ofloxacin, ciprofloxacin, and gatifloxacin were included in Groups B and C.
Estimates for later-generation fluoroquinolones, linezolid, and bedaquiline were adjusted for each other and number of effective Groups B and C drugs in the same model.
Only eight individuals.