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KMID : 0311120200610121034
Yonsei Medical Journal
2020 Volume.61 No. 12 p.1034 ~ p.1041
Characteristics and Treatment Outcomes of Isoniazid Mono-Resistant Tuberculosis: A Retrospective Study
Kwak Se-Hyun

Choi Ji-Soo
Lee Eun-Hye
Lee Su-Hwan
Leem Ah-Young
Lee Sang-Hoon
Kim Song-Yee
Chung Kyung-Soo
Kim Eun-Young
Jung Ji-Ye
Park Moo-Suk
Kim Young-Sam
Chang Joon
Kang Young-Ae
Abstract
Purpose: Isoniazid (INH) mono-resistant tuberculosis (Hr-TB) is a highly prevalent type of drug-resistant TB, possibly associated with unfavorable treatment outcomes. However, definitive guidelines on an optimal treatment regimen and duration for Hr-TB are currently under discussion. We evaluated the characteristics and treatment outcomes of Hr-TB patients.

Materials and Methods: We retrospectively reviewed the medical records of Hr-TB patients treated at a South Korean tertiary referral hospital from January 2005 to December 2018.

Results: We included 195 Hr-TB patients. 113 (57.9%) were male, and the median age was 56.6 [interquartile range, 40.2?68.6] years. Mutations in katG were the most frequent [54 (56.3%)], followed by those in the inhA [34 (35.4%)]. Favorable and unfavorable outcomes were noted in 164 (84.1%) and 31 (15.9%) patients, respectively. Smoking history [odds ratio (OR)=5.606, 95% confidence interval (CI): 1.695?18.543, p=0.005], low albumin level (OR=0.246, 95% CI: 0.104?0.578, p=0.001), and positive acid-fast bacilli culture at 2 months (OR=7.853, 95% CI: 1.246?49.506, p=0.028) were associated with unfavorable outcomes.

Conclusion: A tailored strategy targeting high-risk patients is imperative for improved treatment outcomes. Further research on the rapid and accurate detection of resistance to INH and other companion drugs is warranted.
KEYWORD
Tuberculosis, isoniazid, treatment outcome
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