Assessing TB treatment outcomes in pregnant women living with HIV with drug-susceptible TB.

IF 1.3 Q4 RESPIRATORY SYSTEM

Public Health Action Pub Date : 2025-03-01 DOI:10.5588/pha.24.0051

N Hernandez-Morfin, S Cohn, Z Waja, R E Chaisson, N Martinson, N Salazar-Austin

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Abstract

Background: Limited data exist on TB treatment outcomes among pregnant women with TB. Physiological and immunological adaptations during pregnancy may affect the efficacy of TB treatment. We aimed to evaluate factors associated with unsuccessful TB treatment outcomes among pregnant women living with HIV (PWLHIV) and diagnosed with TB in the Tshepiso study.

Methods: In this secondary analysis, we used multivariable logistic regression to evaluate factors associated with unsuccessful TB treatment outcomes among PWLHIV with drug-sensitive TB disease enrolled in the Tshepiso study in Soweto, South Africa, from 2011-2014.

Results: This analysis includes 79 PWLHIV diagnosed with drug-sensitive TB during pregnancy; 18 (23%) had an unsuccessful treatment outcome. Factors associated with unsuccessful TB treatment include detectable HIV RNA viral load at enrollment to the study (aOR 5.1, 95% CI 1.1-25.3), presence of extrapulmonary TB (aOR 2.2, 95% CI 0.4-11.7), bacteriological (positive smear and/or culture) confirmation of TB (aOR 2.1, 95% CI 0.7-6.7), and anemia (Hb ≤ 10.5 g/dL) (aOR 1.0, 95% CI 0.3-3.1). The only factor with statistical significance was a detectable HIV RNA viral load.

Conclusion: Detectable HIV viral load emerges as a critical factor associated with an unsuccessful TB treatment outcome in pregnant women living with HIV and diagnosed with TB.

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背景：有关结核病孕妇的结核病治疗效果的数据有限。怀孕期间的生理和免疫适应可能会影响结核病的治疗效果。我们的目的是评估在 Tshepiso 研究中被确诊为肺结核的艾滋病病毒感染者（PWLHIV）孕妇中肺结核治疗效果不佳的相关因素：在这项二次分析中，我们使用多变量逻辑回归评估了 2011-2014 年期间在南非索韦托参加 Tshepiso 研究的患有药物敏感性结核病的 PWLHIV 中与结核病治疗结果不成功相关的因素：本分析包括 79 名在怀孕期间被诊断患有药物敏感性结核病的艾滋病毒感染者，其中 18 人（23%）的治疗结果不成功。与结核病治疗不成功相关的因素包括：加入研究时检测到的 HIV RNA 病毒载量（aOR 5.1，95% CI 1.1-25.3）、存在肺外结核病（aOR 2.2，95% CI 0.4-11.7）、结核病细菌学（涂片和/或培养阳性）确认（aOR 2.1，95% CI 0.7-6.7）和贫血（血红蛋白≤10.5 g/dL）（aOR 1.0，95% CI 0.3-3.1）。唯一具有统计学意义的因素是可检测到的 HIV RNA 病毒载量：可检测到的 HIV 病毒载量是导致感染 HIV 并确诊为结核病的孕妇无法成功接受结核病治疗的关键因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Public Health Action RESPIRATORY SYSTEM-

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期刊介绍： Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.