Different profiles of body mass index variation among patients with multidrug-resistant tuberculosis: a retrospective cohort study
In: ISSN: 1471-2334, 2020
Online
academicJournal
Zugriff:
International audience ; Background: Despite the predictive role of body weight variation in treatment outcome in multidrug-resistant tuberculosis (MDR-TB), few corroborating data are available. We studied weight variation in patients with MDR-TB to identify groups of weight change and to determine factors that influence these changes. Methods: We analyzed patients with rifampicin resistance who were treated with an MDR-TB treatment regimen between June 07, 2016 and June 22, 2018 at three major drug-resistant TB centers in Guinea. Patients were seen monthly until the end of treatment. Clinical outcome was the body mass index (BMI). We used a linear mixed model to analyze trajectories of BMI and a latent class mixed model to identify groups of BMI trajectories. Results: Of 232 patients treated for MDR-TB during the study period, 165 were analyzed. These patients had a total of 1387 visits, with a median of 5 visits (interquartile range, 3-8 visits). Monthly BMI increase was 0.24 (SE 0.02) per kg/m2. Factors associated with faster BMI progression were success of MDR-TB treatment (0.24 [SE 0.09] per kg/m2; p = 0.0205) and absence of lung cavities on X-ray (0.18 [0.06] per kg/m2; p = 0.0068). Two groups of BMI change were identified: rapid BMI increase (n = 121; 85%) and slow BMI increase (n = 22; 15%). Patients in the slow BMI increase group were mostly female (68%) had no history of TB treatment (41%), had a positive HIV infection (59%), and had a more severe clinical condition at baseline, characterized by a higher frequency of symptoms including depression (18%), dyspnea (68%), poor adherence to MDR-TB treatment (64%), lower platelet count, and higher SGOT. These patients also had a longer time to initial culture conversion (log-rank test: p = 0.0218). Conclusion: Quantitative BMI data on patients with MDR-TB treated with a short regimen allowed the identification of subgroups of patients with different trajectories of BMI and emphasized the usefulness of BMI as a biomarker for the monitoring of MDR-TB treatment ...
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Different profiles of body mass index variation among patients with multidrug-resistant tuberculosis: a retrospective cohort study
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Autor/in / Beteiligte Person: | Diallo, Alhassane ; Diallo, Boubacar Djelo ; Camara, Lansana Mady ; Kounoudji, Lucrèce Ahouéfa Nadège ; Bah, Boubacar ; N'Zabintawali, Fulgence ; Carlos-Bolumbu, Miguel ; Diallo, Mamadou Hassimiou ; Sow, Oumou Younoussa ; Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord ; Department of Epidemiology, Biostatistics, and Clinical Research Paris ; Centre d'Investigation Clinique – Épidémiologie Clinique Paris ; AP-HP - Hôpital Bichat - Claude Bernard Paris ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP - Hôpital Bichat - Claude Bernard Paris ; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM) ; Université Gamal Abdel Nasser de Conakry ; Centre Antituberculeux de la Carrière Conakry, Guinée ; Laboratoire National des Mycobactéries Conakry, Guinée ; Urgences Réanimation Paris ; Centre Hospitalier Sud Essonnes (CHSE) ; Centre population et développement (CEPED - UMR_D 196) ; Institut de Recherche pour le Développement (IRD)-Université de Paris (UP) |
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Zeitschrift: | ISSN: 1471-2334, 2020 |
Veröffentlichung: | HAL CCSD ; BioMed Central, 2020 |
Medientyp: | academicJournal |
DOI: | 10.1186/s12879-020-05028-0 |
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