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TREATMENT OUTCOME AND ADVERSE EFFECT IN ELDERLY TUBERCULOSIS PATIENTS ACCORDING TO COMORBIDITIES FREE TO VIEW

Seo Yun Kim, MD*; Ju-Seop Kang, MD; Sang-Min Lee, MD; Jae-Jun Yim, MD; Chul-Gyu Yoo, MD; Young Whan Kim, MD; Sung Koo Han, MD; Young-Soo Shim, MD; Seok-Chul Yang, MD
Author and Funding Information

Seoul National University, Seoul, South Korea


Chest


Chest. 2009;136(4_MeetingAbstracts):44S. doi:10.1378/chest.08-2858
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Abstract

PURPOSE:  The aim of this study was to elucidate the influence of immune-compromising co-morbidities on treatment outcome response and adverse effect of anti-tuberculosis (TB) medication in elderly TB patients over age 70 years.

METHODS:  We retrospectively studied 192 patients with pulmonary TB and TB pleurisy over 70 years in a single tertiary referral hospital between January 2004 and December 2007. The patients were classified into immunocompromised patients (ICP) (n=116) and non-immunocompromised patients (Non-ICP) (n=76) depending on co-morbidities causing immune-compromise such as diabetes mellitus, chronic kidney disease, liver cirrhosis, malignancy, immunosuppressive therapy, malnutrition and HIV infection. Treatment response and adverse effects of anti-TB medications were evaluated with negative conversion rate of sputum smear and culture, treatment duration, and treatment outcome (treatment relapse, treatment failure, and TB related death).

RESULTS:  The smear and culture negative conversion rate was 100% in both groups. The treatment response was analyzed in 147 pulmonary TB patients who had completed treatment during the study (n=86 in ICP vs n=61 in Non-ICP). The treatment duration was 8.58 ± 4.85 months in ICP and 9.22 ± 6.12 months in Non-ICP (p=0.48). TB relapse rate was 4.7% vs 6.6% (p=0.71). Treatment failure and TB treatment related mortality death was not observed in both groups. The adverse events of anti-TB treatment were evaluated in 192 patients; the most commonly observed side effects were gastrointestinal trouble (16.4 % vs 11.8%, p=0.38) and skin related side effects including rash or pruritus (9.5 % vs 14.5 %, p=0.28).

CONCLUSION:  There was no difference in treatment outcome response and adverse effect in elderly tuberculosis patients (>70 years) with immune-compromising co-morbidities compared to those without them.

CLINICAL IMPLICATIONS:  The present study suggests immune-compromising co-morbidities in elderly are not an obstacle to tuberculosis treatment.

DISCLOSURE:  Seo Yun Kim, No Financial Disclosure Information; No Product/Research Disclosure Information

Tuesday, November 3, 2009

2:30 PM - 3:30 PM


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