Efficacy of tuberculosis treatment in newly diagnosed cases: a comparative analysis between HIV-positive and HIV-negative patients

Abstract

Background. HIV coinfection remains a major determinant of tuberculosis (TB) treatment outcomes, even with the implementation of updated therapeutic protocols. Its negative impact significantly reduces treatment success rates and compromises the achievement of the Sustainable Development Goals for TB elimination by 2030. Objective(s). To evaluate the efficacy of treatment in newly diagnosed cases of pulmonary tuberculosis by comparing outcomes in HIV-positive and HIV-negative patients based on Mycobacterium susceptibility profiles. Materials and methods. A total of 314 patients diagnosed with tuberculosis were analyzed and divided into two cohorts: cohort I (study group) – 156 patients TB/HIV, and cohort II (control group) – 158 TB. Each cohort was further stratified into three subgroups according to the drug susceptibility profile of resistant TB, sensitive TB, and bacteriologically negative TB. Results. In cohort I, the cure rate was 60.7% for drug-resistant TB and 70.4% for drugsensitive TB, while 88.2% of patients with bacteriologically negative results completed treatment. Mortality was 39.3% in drug-resistant TB, 25.0% in drug-sensitive TB, and 11.8% in negative-result cases; loss to follow-up and treatment failure each accounted for 2.3%. In cohort II, the cure rate for drug-resistant TB was 88.7%, mortality 6.5%, and loss to followup 4.8%; for drug-sensitive TB, the cure rate was 86.4% and mortality 11.3%. Among bacteriologically negative cases, 94.2% completed treatment, with 5.8% lost to follow-up. Conclusion(s). The treatment efficacy in newly diagnosed tuberculosis cases was significantly lower in HIV-coinfected patients compared to HIV-negative individuals, with a higher mortality rate and a lower cure rate observed, regardless of the drug susceptibility profile of patients.