Volume 16, Number 10—October 2010
Research
Therapeutic Drug Monitoring for Slow Response to Tuberculosis Treatment in a State Control Program, Virginia, USA
Scott K. Heysell
, Jane L. Moore, Suzanne J. Keller, and Eric R. Houpt
, Jane L. Moore, Suzanne J. Keller, and Eric R. HouptTable 1
Baseline characteristics of adults treated for drug-susceptible pulmonary TB in a state control program, Virginia, USA, March 1, 2007–May 1, 2009*
| Characteristic | All patients, N = 311, no. (%) | Slow response, n = 42, no. (%) | Normal response, n = 269, no. (%) | Bivariate OR (95% CI); p value |
|---|---|---|---|---|
| Age, y | ||||
| 18–39 | 151 (49) | 16 (38) | 135 (50) | Referent |
| 40–64 | 90 (29) | 13 (31) | 77 (29) | 1.4 (0.65–3.10); p = 0.38 |
| >65 |
70 (22) |
13 (31) |
57 (21) |
1.9 (0.87–4.30); p = 0.11 |
| Sex | ||||
| M | 204 (65) | 29 (69) | 175 (65) | Referent |
| F |
107 (35) |
13 (31) |
94 (35) |
0.84 (0.42–1.70); p = 0.61 |
| Race/ethnicity | ||||
| Asian | 102 (33) | 19 (45) | 83 (31) | Referent |
| Hispanic | 82 (26) | 11 (26) | 71 (26) | 0.67 (0.30–1.50); p = 0.34 |
| Black | 86 (28) | 8 (19) | 78 (29) | 0.45 (0.19–1.10); p = 0.07 |
| White | 41 (13) | 4 (10) | 37 (14) | 0.47 (0.15–1.50); p = 0.20 |
| Native American |
0 |
0 |
0 |
|
| Foreign born | ||||
| No | 83 (27) | 9 (21) | 74 (28) | Referent |
| Yes |
228 (73) |
33 (79) |
195 (72) |
1.4 (0.64–3.00); p = 0.41 |
| Homeless | ||||
| No | 301 (97) | 41 (98) | 260 (97) | Referent |
| Yes |
10 (3) |
1 (2) |
9 (3) |
0.71 (0.09–5.70); p = 0.74 |
| Illicit drug use | ||||
| No | 298 (96) | 42 (100) | 256 (95) | Referent |
| Non-injection use | 7 (2) | 0 | 7 (3) | p>0.99 |
| Injection use |
6 (2) |
0 |
6 (2) |
p>0.99 |
| Alcohol abuse | ||||
| No | 276 (89) | 38 (91) | 238 (89) | Referent |
| Yes |
35 (11) |
4 (9) |
31 (11) |
0.81 (0.27–2.40); p = 0.70 |
| HIV status | ||||
| Negative | 266 (86) | 37 (88) | 229 (85) | Referent |
| Positive | 11 (3) | 0 | 11 (4) | p>0.99 |
| Unknown |
34 (11) |
5 (12) |
29 (11) |
1.1 (0.39–2.90); p = 0.90 |
| Diabetes | ||||
| No | 270 (87) | 25 (60) | 245 (91) | Referent |
| Yes |
41 (13) |
17 (40) |
24 (9) |
6.9 (3.3–14.6); p<0.001† |
| Prior TB history | ||||
| No | 291 (93) | 38 (91) | 253 (94) | Referent |
| Yes | 18 (6) | 3 (7) | 15 (5) | 1.3 (0.37–4.80); p = 0.66 |
| Unknown |
2 (1) |
1 (2) |
1 (1) |
6.6 (0.41–108.70); p = 0.18 |
| Tuberculin skin test result | ||||
| Negative | 47 (15) | 5 (12) | 42 (16) | Referent |
| Positive | 179 (58) | 23 (55) | 156 (58) | 1.2 (0.44–3.50); p = 0.68 |
| Unavailable |
85 (27) |
14 (33) |
71 (26) |
1.7 (0.56–4.90); p = 0.36 |
| Sputum smear | ||||
| Negative | 94 (30) | 9 (21) | 85 (31) | Referent |
| Positive | 193 (62) | 30 (72) | 163 (61) | 1.7 (0.79–3.80); p = 0.17 |
| Not done |
24 (8) |
3 (7) |
21 (8) |
1.3 (0.34–5.40); p = 0.67 |
| Chest radiograph | ||||
| No TB findings | 16 (5) | 2 (5) | 14 (5) | Referent |
| Noncavitary | 173 (56) | 19 (45) | 154 (57) | 0.86 (0.18–4.10); p = 0.85 |
| Cavitary |
122 (39) |
21 (50) |
101 (38) |
1.5 (0.31–6.80); p = 0.64 |
| Disease site | ||||
| Pulmonary | 212 (68) | 32 (76) | 180 (67) | Referent |
| Pulmonary/extrapulmonary | 99 (32) | 10 (24) | 89 (33) | 0.63 (0.30–1.30); p = 0.23 |
*Tuberculin skin test values recorded in surveillance database as positive based on guidelines from the American Thoracic Society and Centers for Disease Control and Prevention (15). TB, tuberculosis; OR, odds ratio; CI, confidence interval.
†Adjusted odds ratio 6.3 (95% CI 2.8–14.0); p<0.001.
