Association between HIV and acquisition of rifamycin resistance with first-line TB treatment: a systematic review and meta-analysis. Zinyakatira, N., Ford, N., & Cox, H. BMC Infectious Diseases, 24(1):1–13, BioMed Central Ltd, dec, 2024. Paper doi abstract bibtex Background: Multi-drug or rifamycin-resistant tuberculosis (MDR/RR-TB) is an important public health concern, including in settings with high HIV prevalence. TB drug resistance can be directly transmitted or arise through resistance acquisition during first-line TB treatment. Limited evidence suggests that people living with HIV (PLHIV) might have an increased risk of acquired rifamycin-resistance (ARR). Methods: To assess HIV as a risk factor for ARR during first-line TB treatment, a systematic review and meta-analysis was conducted. ARR was defined as rifamycin-susceptibility at treatment start with rifamycin-resistance diagnosed during or at the end of treatment, or at recurrence. PubMed/MEDLINE, CINAHL, Cochrane Library, and Google Scholar databases were searched from inception to 23 May 2024 for articles in English; conference abstracts were also searched from 2004 to 2021. The Mantel-Haenszel random-effects model was used to estimate the pooled odds ratio of any association between HIV and ARR among individuals receiving first-line TB treatment. Results: Ten studies that included data collected between 1990 and 2014 were identified: five from the United States, two from South Africa and one each from Uganda, India and Moldova. A total of 97,564 individuals were included across all studies, with 13,359 (13.7%) PLHIV. Overall, 312 (0.32%) acquired rifamycin-resistance, among whom 115 (36.9%) were PLHIV. The weighted odds of ARR were 4.57 (95% CI, 2.01–10.42) times higher among PLHIV compared to HIV-negative individuals receiving first-line TB treatment. Conclusion: The available data, suggest that PLHIV have an increased ARR risk during first-line TB treatment. Further research is needed to clarify specific risk factors, including advanced HIV disease and TB disease severity. Given the introduction of shorter, 4-month rifamycin-based regimens, there is an urgent need for additional data on ARR, particularly for PLHIV. Systematic review registration: PROSPERO CRD42022327337.
@article{Zinyakatira2024,
abstract = {Background: Multi-drug or rifamycin-resistant tuberculosis (MDR/RR-TB) is an important public health concern, including in settings with high HIV prevalence. TB drug resistance can be directly transmitted or arise through resistance acquisition during first-line TB treatment. Limited evidence suggests that people living with HIV (PLHIV) might have an increased risk of acquired rifamycin-resistance (ARR). Methods: To assess HIV as a risk factor for ARR during first-line TB treatment, a systematic review and meta-analysis was conducted. ARR was defined as rifamycin-susceptibility at treatment start with rifamycin-resistance diagnosed during or at the end of treatment, or at recurrence. PubMed/MEDLINE, CINAHL, Cochrane Library, and Google Scholar databases were searched from inception to 23 May 2024 for articles in English; conference abstracts were also searched from 2004 to 2021. The Mantel-Haenszel random-effects model was used to estimate the pooled odds ratio of any association between HIV and ARR among individuals receiving first-line TB treatment. Results: Ten studies that included data collected between 1990 and 2014 were identified: five from the United States, two from South Africa and one each from Uganda, India and Moldova. A total of 97,564 individuals were included across all studies, with 13,359 (13.7{\%}) PLHIV. Overall, 312 (0.32{\%}) acquired rifamycin-resistance, among whom 115 (36.9{\%}) were PLHIV. The weighted odds of ARR were 4.57 (95{\%} CI, 2.01–10.42) times higher among PLHIV compared to HIV-negative individuals receiving first-line TB treatment. Conclusion: The available data, suggest that PLHIV have an increased ARR risk during first-line TB treatment. Further research is needed to clarify specific risk factors, including advanced HIV disease and TB disease severity. Given the introduction of shorter, 4-month rifamycin-based regimens, there is an urgent need for additional data on ARR, particularly for PLHIV. Systematic review registration: PROSPERO CRD42022327337.},
author = {Zinyakatira, Nesbert and Ford, Nathan and Cox, Helen},
doi = {10.1186/S12879-024-09514-7/FIGURES/3},
file = {:C$\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Zinyakatira, Ford, Cox - 2024 - Association between HIV and acquisition of rifamycin resistance with first-line TB treatment a systemati.pdf:pdf},
issn = {14712334},
journal = {BMC Infectious Diseases},
keywords = {Acquired rifamycin-resistance systematic review,Human immunodeficiency virus,Meta-analysis,OA,Tuberculosis,fund{\_}not{\_}ack,original},
mendeley-tags = {OA,fund{\_}not{\_}ack,original},
month = {dec},
number = {1},
pages = {1--13},
publisher = {BioMed Central Ltd},
title = {{Association between HIV and acquisition of rifamycin resistance with first-line TB treatment: a systematic review and meta-analysis}},
url = {https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09514-7 http://creativecommons.org/publicdomain/zero/1.0/},
volume = {24},
year = {2024}
}
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PubMed/MEDLINE, CINAHL, Cochrane Library, and Google Scholar databases were searched from inception to 23 May 2024 for articles in English; conference abstracts were also searched from 2004 to 2021. The Mantel-Haenszel random-effects model was used to estimate the pooled odds ratio of any association between HIV and ARR among individuals receiving first-line TB treatment. Results: Ten studies that included data collected between 1990 and 2014 were identified: five from the United States, two from South Africa and one each from Uganda, India and Moldova. A total of 97,564 individuals were included across all studies, with 13,359 (13.7%) PLHIV. Overall, 312 (0.32%) acquired rifamycin-resistance, among whom 115 (36.9%) were PLHIV. The weighted odds of ARR were 4.57 (95% CI, 2.01–10.42) times higher among PLHIV compared to HIV-negative individuals receiving first-line TB treatment. Conclusion: The available data, suggest that PLHIV have an increased ARR risk during first-line TB treatment. Further research is needed to clarify specific risk factors, including advanced HIV disease and TB disease severity. Given the introduction of shorter, 4-month rifamycin-based regimens, there is an urgent need for additional data on ARR, particularly for PLHIV. 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