Ivaan Pitua, Marvin Kirya, Denis Kiberu, Shivan Nabaasa, Amelia Margaret Namiiro, Michael Collins Segawa, Patrick Semakula, Sarah Maria Najjuka, Joseph Baruch Baluku, Ronald Olum
{"title":"乌干达感染艾滋病毒并耐药结核病的青少年和年轻人的特点和治疗结果：一项回顾性队列研究","authors":"Ivaan Pitua, Marvin Kirya, Denis Kiberu, Shivan Nabaasa, Amelia Margaret Namiiro, Michael Collins Segawa, Patrick Semakula, Sarah Maria Najjuka, Joseph Baruch Baluku, Ronald Olum","doi":"10.1177/20499361251319655","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains a significant global health challenge, especially among people living with HIV. Drug-resistant TB (DR-TB) complicates treatment outcomes in high-burden countries like Uganda, particularly for adolescents and young adults living with HIV (AYALH).</p><p><strong>Objectives: </strong>We described the characteristics, treatment outcomes, and factors associated with treatment success among AYALH and DR-TB at a TB treatment unit in Mulago National Referral Hospital, Kampala, Uganda.</p><p><strong>Design: </strong>A retrospective cohort study was conducted.</p><p><strong>Methods: </strong>Medical records of AYALH treated for DR-TB between January 2013 and December 2021 were reviewed. Descriptive statistics and multivariable logistic regression were used to analyze treatment outcomes and associated factors.</p><p><strong>Results: </strong>Among 327 participants (mean age: 28.2 years, SD: 4.75; 52.6% male), the treatment success rate was 65.7%. A body mass index (BMI) ⩾ 18.5 kg/m<sup>2</sup> (adjusted odds ratio [aOR]: 0.53, 95% CI: 0.33-0.83, <i>p</i> = 0.005), Efavirenz-based antiretroviral therapy (ART) regimens (aOR: 0.56, 95% CI: 0.35-0.89, <i>p</i> = 0.014), and primary DR-TB (aOR: 0.42, 95% CI: 0.28-0.64, <i>p</i> < 0.001) were significantly associated with treatment success.</p><p><strong>Conclusion: </strong>The study revealed a treatment success in only two-thirds of participants emphasizing persistent challenge of achieving optimal treatment outcomes for AYALH. The findings highlight that a higher BMI and Efavirenz-based ART regimens are significantly associated with improved treatment success pointing to the necessity for addressing nutritional needs and optimizing ART regimens to improve the management of DR-TB among AYALH.</p>","PeriodicalId":46154,"journal":{"name":"Therapeutic Advances in Infectious Disease","volume":"12 ","pages":"20499361251319655"},"PeriodicalIF":3.8000,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822808/pdf/","citationCount":"0","resultStr":"{\"title\":\"Characteristics and treatment outcomes of adolescents and young adults living with HIV with drug-resistant tuberculosis co-infection in Uganda: a retrospective cohort study.\",\"authors\":\"Ivaan Pitua, Marvin Kirya, Denis Kiberu, Shivan Nabaasa, Amelia Margaret Namiiro, Michael Collins Segawa, Patrick Semakula, Sarah Maria Najjuka, Joseph Baruch Baluku, Ronald Olum\",\"doi\":\"10.1177/20499361251319655\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Tuberculosis (TB) remains a significant global health challenge, especially among people living with HIV. Drug-resistant TB (DR-TB) complicates treatment outcomes in high-burden countries like Uganda, particularly for adolescents and young adults living with HIV (AYALH).</p><p><strong>Objectives: </strong>We described the characteristics, treatment outcomes, and factors associated with treatment success among AYALH and DR-TB at a TB treatment unit in Mulago National Referral Hospital, Kampala, Uganda.</p><p><strong>Design: </strong>A retrospective cohort study was conducted.</p><p><strong>Methods: </strong>Medical records of AYALH treated for DR-TB between January 2013 and December 2021 were reviewed. Descriptive statistics and multivariable logistic regression were used to analyze treatment outcomes and associated factors.</p><p><strong>Results: </strong>Among 327 participants (mean age: 28.2 years, SD: 4.75; 52.6% male), the treatment success rate was 65.7%. A body mass index (BMI) ⩾ 18.5 kg/m<sup>2</sup> (adjusted odds ratio [aOR]: 0.53, 95% CI: 0.33-0.83, <i>p</i> = 0.005), Efavirenz-based antiretroviral therapy (ART) regimens (aOR: 0.56, 95% CI: 0.35-0.89, <i>p</i> = 0.014), and primary DR-TB (aOR: 0.42, 95% CI: 0.28-0.64, <i>p</i> < 0.001) were significantly associated with treatment success.</p><p><strong>Conclusion: </strong>The study revealed a treatment success in only two-thirds of participants emphasizing persistent challenge of achieving optimal treatment outcomes for AYALH. The findings highlight that a higher BMI and Efavirenz-based ART regimens are significantly associated with improved treatment success pointing to the necessity for addressing nutritional needs and optimizing ART regimens to improve the management of DR-TB among AYALH.</p>\",\"PeriodicalId\":46154,\"journal\":{\"name\":\"Therapeutic Advances in Infectious Disease\",\"volume\":\"12 \",\"pages\":\"20499361251319655\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2025-02-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822808/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Infectious Disease\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/20499361251319655\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Infectious Disease","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/20499361251319655","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Characteristics and treatment outcomes of adolescents and young adults living with HIV with drug-resistant tuberculosis co-infection in Uganda: a retrospective cohort study.
Background: Tuberculosis (TB) remains a significant global health challenge, especially among people living with HIV. Drug-resistant TB (DR-TB) complicates treatment outcomes in high-burden countries like Uganda, particularly for adolescents and young adults living with HIV (AYALH).
Objectives: We described the characteristics, treatment outcomes, and factors associated with treatment success among AYALH and DR-TB at a TB treatment unit in Mulago National Referral Hospital, Kampala, Uganda.
Design: A retrospective cohort study was conducted.
Methods: Medical records of AYALH treated for DR-TB between January 2013 and December 2021 were reviewed. Descriptive statistics and multivariable logistic regression were used to analyze treatment outcomes and associated factors.
Results: Among 327 participants (mean age: 28.2 years, SD: 4.75; 52.6% male), the treatment success rate was 65.7%. A body mass index (BMI) ⩾ 18.5 kg/m2 (adjusted odds ratio [aOR]: 0.53, 95% CI: 0.33-0.83, p = 0.005), Efavirenz-based antiretroviral therapy (ART) regimens (aOR: 0.56, 95% CI: 0.35-0.89, p = 0.014), and primary DR-TB (aOR: 0.42, 95% CI: 0.28-0.64, p < 0.001) were significantly associated with treatment success.
Conclusion: The study revealed a treatment success in only two-thirds of participants emphasizing persistent challenge of achieving optimal treatment outcomes for AYALH. The findings highlight that a higher BMI and Efavirenz-based ART regimens are significantly associated with improved treatment success pointing to the necessity for addressing nutritional needs and optimizing ART regimens to improve the management of DR-TB among AYALH.
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