PT  - JOURNAL ARTICLE
AU  - Marina Kikvidze
AU  - Lali Ikiashvili
TI  - Comorbidities and MDR-TB treatment outcomes in Georgia- 2009-11 cohort
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P1444
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P1444.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P1444.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Background. Treatment of MDR-TB is complex and chemotherapy course's outcome depends on many factors. Comorbidities may complicate TB disease and effect treatment response.Aims and objectives. The aim of the study was comparison of chemotherapy response among patients with and those without comorbidities in a setting of individualized MDR-TB care and adequate management of all diseases.Methods. We conducted a retrospective cohort study of 1970 drug-resistant tuberculosis patients integrated in DOTS+ programme in 2009-2011 years in Georgia. Patients were routinely investigated for HIV, diabetes mellitus (DM) and viral hepatitis. Documentary approved diagnoses of other diseases were taken in account. Dispersive analysis using Mann-Whitney/Wilcoxon Two-Sample Test was provided to compare the treatment outcomes of patients with and those without comorbidity.Results. Of 1970 patients with drug-resistant tuberculosis 486(24,7%) had one or more comorbidity. 223 patient(11,3%) had liver diseases, DM-104(5,2%), HIV-72(3,7%), Psychiatric diseases - 53(2,7%), other-55(2,9%). Definition “success” received 966(49%) patient:44,0% with comorbidities vs 50,7%-without(p=0,01),“Default”-30,5% vs 28,4%, “Failure”- 4,1% vs 4,0(p>0,05, CI-95%),“Death”- 10,7% vs 5,7%(p<0,05, CI-95%).Mortality rate was highest during HIV-co-infection(RR-3, 73, 95% CI 2,38-5,86, p<0, 05). Definition “success” was lowest during HIV-co-infection(RR-0,67, 95%CI48-0,93, p<0,05) and chronic viral hepatitis ”C”(RR-0,79, 95%CI 0,66-0,95, p<0,05).Conclusions. Our cohort study revealed that comorbidities had serious impact on treatment outcomes andwere associated with significant lower successful treatment outcomes and about twice higher death rate.