Risk factors for 1-year relapse of pulmonary tuberculosis treated with a 6-month daily regimen

초록

Background: We aimed to identify the 1-year relapse rate and risk factors for patients with pulmonary tuberculosis (TB) treated with a 6-month daily regimen. Methods: A total of 317 patients with pan-susceptible pulmonary TB who completed a 6-month daily course of treatment [2HRZ(E)/4HR(E)] were retrospectively analyzed. Results: The mean age was 50.0 +/- 16.8 years and men were predominant (61.2%). All of 137 adults tested for HIV were negative. Six (1.9%) cases relapsed within one year. Relapse rate was higher in patients with a positive culture after 2 months of treatment (10.0%, p = 0.049) and in patients with both a positive culture after 2 months of treatment and cavitation on initial chest radiograph (18.2%, p = 0.015), whereas relapse rate in patients with cavitation alone was comparable to that of the total population (2.7%). Among various risk factors known to increase risk of relapse, the combined variable of cavitation and positive culture at 2 months (OR = 15.56, 95% Cl 2.56-98.71, p = 0.003) was only associated with increased relapse rate in a multivariate analysis. Conclusions: Even with a 6-month daily treatment regimen throughout the intensive and continuation phases, the relapse rate was unacceptably high in patients with both a positive culture at 2 months of treatment and cavitation on baseline chest radiography. Intensification of treatment, such as an extension of treatment duration, should be considered in this category of patients. (C) 2014 Elsevier Ltd. All rights reserved.

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