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.
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).
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).
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.
The present study suggests immune-compromising co-morbidities in elderly are not an obstacle to tuberculosis treatment.
Seo Yun Kim, No Financial Disclosure Information; No Product/Research Disclosure Information