Treatment outcomes in patients with drug-resistant TB-HIV coinfection treated with bedaquiline and linezolid

Padayatchi, N.
Bionghi, N.
Osman, F.
Naidu, N.
Ndjeka, N.
Master, I.
Brust, J. C. M.
Naidoo, K.
Ramjee, A.
O Donnell, M.
Background: Bedaquiline has not been extensively studied among HIV drug-resistant tuberculosis (DR-TB) co-infected patients. We compared treatment outcomes in DR-TB patients treated with bedaquiline- and linezolid-containing regimens to historic controls treated with second-line injectable-containing regimens. Methods: Retrospective cohort study of consecutive DR-TB patients initiated on bedaquiline- and linezolid-containing regimens at a TB referral hospital in KwaZulu-Natal, South Africa. Participants were prospectively followed through 24 months for treatment outcome, and adverse events. Outcomes were compared to a historic control cohort of DR-TB HIV patients enrolled at the same facility prior to bedaquiline introduction. Results: Adult DR-TB patients initiating bedaquiline between January 2014 and November 2015 were enrolled (N=151). The majority of patients were female (52%), HIV co-infected (77%) and on antiretroviral therapy (100%). End of treatment outcomes included cure (63%), TB culture conversion (83%), completion (0.7%), loss-to-follow-up (15%), treatment failure (5%), and death (17%). Compared to historic controls (N=105), patients treated with bedaquiline experienced significantly higher TB culture conversion and cure, with significantly lower mortality. Adverse effects were common (92%) and most frequently attributed to linezolid (24.1%). QT segment prolongation was common but without clinical sequelae. Conclusion: Treatment with bedaquiline- and linezolid-containing regimens was associated with improved treatment outcomes and survival in DR-TB HIV patients.
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Ingeta Connect
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TB-HIV co-infection,Treatment outcomes,Bedaquiline,Linezolid
Padayatchi N, Bionghi N, Osman F, Naidu N, Ndjeka N, Master I, Brust JCM, Naidoo K, Ramjee A, O Donnell M. Treatment outcomes in patients with drug-resistant TB-HIV co-infection treated with bedaquiline and linezolid. Int J Tuberc Lung Dis. 2020 Oct 1;24(10):1024-1031. doi: 10.5588/ijtld.20.0048.
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