| Title |
Recurrent tuberculosis among HIV-coinfected patients: a case series from KwaZulu-Natal
|
|---|---|
| Published in |
Infection and Drug Resistance, September 2018
|
| DOI | 10.2147/idr.s150644 |
| Pubmed ID | |
| Authors |
Kogieleum Naidoo, Navisha Dookie, Kasavan Naidoo, Nonhlanhla Yende-Zuma, Benjamin Chimukangara, Ambika Bhushan, Dhineshree Govender, Santhanalakshmi Gengiah, Nesri Padayatchi |
| Abstract |
Recurrent tuberculosis (TB) following TB treatment completion in HIV-infected individuals remains a major public health burden. We assessed the role of various risk factors in mediating the development of recurrent TB and subsequent resistance to antiretroviral therapy and anti-TB drugs. We analyzed secondary demographic, clinical, and laboratory data from medical records of five HIV-infected TB patients enrolled between 2009 and 2014 in a prospective observational study investigating TB recurrence. Paired clinical isolates of Myco-bacterium tuberculosis were typed by IS6110 restriction fragment length polymorphism analysis to determine the mechanism of TB recurrence. Plasma samples were genotyped to determine acquisition of HIV drug resistance mutations on antiretroviral treatment (ART). All five patients were HIV-coinfected, with a previous history of TB infection and prior exposure to anti-TB treatment, and residual lung damage, and demonstrated poor treatment adherence - significant risk factors linked to the development of recurrent TB disease. Furthermore, three of the five patients had multiple episodes of drug-susceptible TB infection with subsequent drug-resistant TB infection. Genotyping of the initial and recurrent M. tuberculosis isolates demonstrated three cases of recurrent TB because of relapse and two because of reinfection. All five patients had no mutations at ART initiation; however, by the end of the study follow-up, all patients developed dual class resistance. This series demonstrates the complexity of recurrent TB in HIV coinfection. We highlight the challenges of managing coinfected patients and the increased propensity for the development of drug resistance. We report on the role of various risk factors mediating the development of resistance and subsequent clinical impact. This report underscores the need for structural clinical and adherence interventions for the management of complex treatment and dosing. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 82 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 82 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 12 | 15% |
| Researcher | 10 | 12% |
| Librarian | 7 | 9% |
| Student > Ph. D. Student | 6 | 7% |
| Lecturer | 4 | 5% |
| Other | 17 | 21% |
| Unknown | 26 | 32% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 16 | 20% |
| Nursing and Health Professions | 11 | 13% |
| Unspecified | 8 | 10% |
| Agricultural and Biological Sciences | 3 | 4% |
| Immunology and Microbiology | 3 | 4% |
| Other | 13 | 16% |
| Unknown | 28 | 34% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 December 2018.
All research outputs
#15,544,609
of 23,102,082 outputs
Outputs from Infection and Drug Resistance
#744
of 1,699 outputs
Outputs of similar age
#212,463
of 335,775 outputs
Outputs of similar age from Infection and Drug Resistance
#44
of 80 outputs
Altmetric has tracked 23,102,082 research outputs across all sources so far. This one is in the 22nd percentile – i.e., 22% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,699 research outputs from this source. They receive a mean Attention Score of 3.8. This one is in the 44th percentile – i.e., 44% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 335,775 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 28th percentile – i.e., 28% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 80 others from the same source and published within six weeks on either side of this one. This one is in the 36th percentile – i.e., 36% of its contemporaries scored the same or lower than it.