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. 2008 Aug 13;3(8):e2957.
doi: 10.1371/journal.pone.0002957.

Management of extensively drug-resistant tuberculosis in Peru: cure is possible

Cesar A Bonilla  1 , Aldo Crossa, Hector O Jave, Carole D Mitnick, Ronal B Jamanca, Cesar Herrera, Luis Asencios, Alberto Mendoza, Jaime Bayona, Matteo Zignol, Ernesto Jaramillo
Affiliations

Management of extensively drug-resistant tuberculosis in Peru: cure is possible

Cesar A Bonilla et al. PLoS One. .

Abstract

Aim: To describe the incidence of extensive drug-resistant tuberculosis (XDR-TB) reported in the Peruvian National multidrug-resistant tuberculosis (MDR-TB) registry over a period of more than ten years and present the treatment outcomes for a cohort of these patients.

Methods: From the Peruvian MDR-TB registry we extracted all entries that were approved for second-line anti-TB treatment between January 1997 and June of 2007 and that had Drug Susceptibility Test (DST) results indicating resistance to both rifampicin and isoniazid (i.e. MDR-TB) in addition to results for at least one fluoroquinolone and one second-line injectable (amikacin, capreomycin and kanamycin).

Results: Of 1,989 confirmed MDR-TB cases with second-line DSTs, 119(6.0%) XDR-TB cases were detected between January 1997 and June of 2007. Lima and its metropolitan area account for 91% of cases, a distribution statistically similar to that of MDR-TB. A total of 43 XDR-TB cases were included in the cohort analysis, 37 of them received ITR. Of these, 17(46%) were cured, 8(22%) died and 11(30%) either failed or defaulted treatment. Of the 14 XDR-TB patients diagnosed as such before ITR treatment initiation, 10 (71%) were cured and the median conversion time was 2 months.

Conclusion: In the Peruvian context, with long experience in treating MDR-TB and low HIV burden, although the overall cure rate was poor, a large proportion of XDR-TB patients can be cured if DST to second-line drugs is performed early and treatment is delivered according to the WHO Guidelines.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

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