Major challenges in clinical management of TB/HIV coinfected patients in Eastern Europe compared with Western Europe and Latin America. PLoS ONE
Efsen et al. on behalf of the TB:HIV study group in EuroCoord aimed to study clinical characteristics, factors associated with multi-drug resistant tuberculosis (MDR-TB) and predicted activity of empiric anti-TB treatment at time of TB diagnosis among TB/HIV coinfected patients in Eastern Europe (EE), Western Europe (WE) and Latin America (LA). In both EE and LA, fewer patients had a definite TB diagnosis (47% and 40%, respectively, vs. 71% and 72% in WE and SE, respectively). The prevalence of MDR-TB in EE ranged from 11–56% between countries. Injecting drug use (adjusted odds ratio (aOR) = 2.03), prior anti-TB treatment (3.42), and living in EE (7.19) were associated with MDR-TB. The proportion of participants who received treatment with at least three active drugs ranged from 66% in EE to 90–96% in the other regions (p<0.0001).
The study-findings demonstrate a clear need for improving and implementing more accurate and rapidly available diagnostics and for providing better empiric anti-TB treatment, particularly in EE.