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Volume 23, Number 10—October 2017
Research Letter

Six-Month Response to Delamanid Treatment in MDR TB Patients

Cathy HewisonComments to Author , Gabriella Ferlazzo, Zaza Avaliani, Armen Hayrapetyan, Sylvie Jonckheere, Zarema Khaidarkhanova, Erika Mohr, Animesh Sinha, Alena Skrahina, Debrah Vambe, Irina Vasilyeva, Nathalie Lachenal, and Francis Varaine
Author affiliations: Médecins Sans Frontières, Paris, France (C. Hewison, F. Varaine); Médecins Sans Frontières, Cape Town, South Africa (G. Ferlazzo, E. Mohr); National Center for Tuberculosis and Lung Diseases, Tbilisi, Georgia (Z. Avaliani); National Tuberculosis Control Centre Ministry of Health, Yerevan, Armenia (A. Hayrapetyan); Médecins Sans Frontières, Johannesburg, South Africa (S. Jonckheere); Republican Tuberculosis Dispensary, Grozny, Chechnya, Russian Federation (Z. Khaidarkhanova); Médecins Sans Frontières, Minsk, Belarus (A. Sinha); Republican Research and Practical Centre for Pulmonology and Tuberculosis, Minsk (A. Skrahina); Swaziland National Tuberculosis Control Program, Mbabane, Swaziland (D. Vambe); Research Institute of Phthisiopulmonology of I.M. Sechenov First MSMU, Moscow, Russian Federation (I. Vasilyeva); Médecins Sans Frontières, Geneva, Switzerland (N. Lachenal)

Main Article

Table

Demographic, clinical, and bacteriological characteristics at baseline of 53 patients starting a delamanid-containing MDR TB treatment regimen*

Variable
No. (%) patients or median (IQR)
Sex
   M 36 (67.9)
   F
 17 (32.1)
Age at delamanid start, y 29.5 (20.0–43.0)
   14–17
 11 (20.8)
HIV co-infected, n = 48 8 (16.7)
HCV co-infected, n = 42 8 (19.0)
Malnutrition,† n = 51 21 (41.2)
Serum albumin at delamanid start, g/L, n = 46
 37.6 (32.0–37.6)
WHO case definition
   New case 4 (7.5)
   Relapse 5 (9.4)
   Treatment after being lost to follow-up 5 (9.4)
   Treatment after failure 32 (60.4)
   Other
7 (13.5)
Previously treated 49 (92.4)
   With first-line drugs only 1 (2.1)
   With second-line drugs 48 (97.9)
   MDR TB confirmed
51 (96.2)
Drug resistance subgroups among confirmed MDR TB
   MDR TB only‡ 10 (19.6)
   Pre–XDR TB FQ 6 (11.8)
   Pre–XDR TB Inj 8 (15.7)
   XDR TB
27 (52.9)
Radiograph features
   Bilateral, n = 45 35 (77.8)
   Cavities, n = 43 26 (60.5)
   Bilateral or cavity, n = 45
 40 (88.9)
Culture positive at delamanid start
37 (69.8)
*HCV, hepatitis C virus serology; HIV, human immunodeficiency virus; MDR TB, multidrug-resistant tuberculosis; pre–XDR TB FQ, MDR TB with fluoroquinolone resistance; pre–XDR TB Inj, MDR TB with resistance to injectable drugs; WHO, World Health Organization; XDR TB, extensively drug-resistant tuberculosis. 
†Malnutrition: either BMI <18.5 kg2/cm, mid-upper arm circumference 
<16cm, or weight <50 kg in 3 patients from South Africa without height measurement. 
‡Without resistance to fluoroquinolone or injectable drugs.

Main Article

Page created: September 19, 2017
Page updated: September 19, 2017
Page reviewed: September 19, 2017
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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