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dc.contributor.authorFranke, MF
dc.contributor.authorKhan, P
dc.contributor.authorHewison, C
dc.contributor.authorKhan, U
dc.contributor.authorHuerga, H
dc.contributor.authorSeung, KJ
dc.contributor.authorRich, ML
dc.contributor.authorZarli, K
dc.contributor.authorSamieva, N
dc.contributor.authorOyewusi, L
dc.contributor.authorNair, P
dc.contributor.authorMudassar, M
dc.contributor.authorMelikyan, N
dc.contributor.authorLenggogeni, P
dc.contributor.authorLecca, L
dc.contributor.authorKumsa, A
dc.contributor.authorKhan, M
dc.contributor.authorIslam, S
dc.contributor.authorHussein, K
dc.contributor.authorDocteur, W
dc.contributor.authorChumburidze, N
dc.contributor.authorBerikova, E
dc.contributor.authorAtshemyan, H
dc.contributor.authorAtwood, S
dc.contributor.authorAlam, M
dc.contributor.authorAhmed, S
dc.contributor.authorBastard, M
dc.contributor.authorMitnick, CD
dc.contributor.authorendTB observational study team
dc.date.accessioned2020-10-21T16:54:27Z
dc.date.available2020-10-21T16:54:27Z
dc.date.issued2020-07-24
dc.date.submitted2020-10-06
dc.identifier.pmid32706644
dc.identifier.doi10.1164/rccm.202001-0135OC
dc.identifier.urihttp://hdl.handle.net/10144/619743
dc.descriptionWe regret that this article is behind a paywall.en_US
dc.description.abstractBackground Bedaquiline and delamanid offer the possibility of more effective and less toxic multidrug-resistant tuberculosis (MDR-TB) treatment. With this treatment, however, some patients, remain at high risk for an unfavorable treatment outcome. The endTB observational study is the largest multicountry cohort of patients with rifampin-resistant/MDR-TB treated in routine care, according to WHO guidance, with delamanid- and/or bedaquiline-containing regimens. We report frequency of sputum culture conversion within six-months of treatment initiation and risk factors for non-conversion. Methods We included patients with a positive baseline culture who initiated a first endTB regimen prior to April 2018. Two consecutive negative cultures collected > 15 days apart constituted culture conversion. We used generalized mixed models to derive marginal predictions for the probability of culture conversion in key subgroups. Findings 1,109 patients initiated a multidrug treatment containing bedaquiline (63%), delamanid (27%) or both (10%). Of these, 939 (85%) experienced culture conversion within six months. In adjusted analyses, patients with HIV had a lower probability of conversion (0·73 [95% CI: 0·62, 0·84]) than patients without HIV (0·84 [95% CI: 0·79, 0·90]; p=0·03). Patients with both cavitary disease and highly positive sputum smear had a lower probability of conversion (0·68 [95% CI: 0·57, 0·79]) relative to patients without either (0·89; 95% CI: 0·84, 0·95; p=0·0004). Hepatitis C infection, diabetes mellitus/glucose intolerance, and baseline resistance were not associated with conversion. Interpretation Frequent sputum conversion in patients with rifampin-resistant/MDR-TB who were treated with bedaquiline and/or delamanid underscores the need for urgent expanded access to these drugs. There is a need to optimize treatment for patients with HIV and extensive disease.en_US
dc.language.isoenen_US
dc.publisherATS Journalsen_US
dc.subjectextensively drug-resistant tuberculosis
dc.subjectinterim outcome
dc.subjectmultidrug-resistant tuberculosis
dc.subjectrifampicin-resistant tuberculosis
dc.subjectsputum conversion
dc.titleCulture Conversion in Patients Treated with Bedaquiline and/or Delamanid: A Prospective Multi-country Study.en_US
dc.typeArticle
dc.identifier.eissn1535-4970
dc.identifier.journalAmerican Journal of Respiratory and Critical Care Medicineen_US
dc.source.journaltitleAmerican journal of respiratory and critical care medicine
dc.source.countryUnited States


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