Low Body Mass Index at Treatment Initiation and Rifampicin-Resistant Tuberculosis Treatment Outcomes: An Individual Participant Data Meta-Analysis

alexandrossfakianakis shared this article with you from Inoreader Low Body Mass Index at Treatment Initiation and Rifampicin-Resistant Tuberculosis Treatment Outcomes: An Individual Participant Data Meta-Analysis Via Clinical Infectious Diseases Advance Access Abstract Background The impact of low body-mass-index at treatment initiation on rifampicin-resistant tuberculosis treatment outcomes is uncertain. We evaluated the association between body-mass-index at rifampicin-resistant tuberculosis treatment initiation and end-of-treatment outcomes, and its modifying factors. Methods We did an individual participant data meta-analysis of adults ≥18 years with rifampicin-resistant tuberculosis whose body-mass-index was documented at treatment initiation. We compared odds of any unfavorable treatment outcome, mortality, or failure/recurrence between patients who were underweight (body-mass-index <18.5 kg/m2) and not underweight. Adjusted odds ratios and 95%CI were estimated using logistic regression, with matching on demographic, clinical, and treatment-related factors. We evaluated effect modification by HIV-infection and other variables using likelihood ratio tests. In secondary an alysis, we estimated cumulative incidence of mortality during treatment, stratified by HIV-infection. Results Overall, 5148 patients were included; 1702 (33%) were underweight at treatment initiation. The median (IQR) age was 37 years (29 to 47) and 455 (9%) were living with HIV. Compared to non-underweight patients, the adjusted odds ratio among underweight patients was 1.7 (95%CI 1.4-1.9) for any unfavorable outcome, 3.1 (2.4-3.9) for death, and 1.6 (1.2-2.0) for failure/recurrence. Significant effect modification was observed for WHO region where the participant was treated. Among patients without HIV, cumulative incidence of 24-month mortality 14.8% (95%CI 12.7%-17.3%) for underweight and 5.6% (4.5%-7.0%) for not underweight patients. Among patients living with HIV, corresponding values were 33.0% (25.6%-42.6%) and 20.9% (14.1%-27.6%). Conclusions Low body-mass-index at treatment initiation for rifampicin-resistant tuberculosis is associated with increased odds of unfavorable treatment outcome, particularly mortality. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.