Gert van der Hoek
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Drug-Resistant Tuberculosis May Be Treatable, Researchers Say
By Chantal Britt
Aug. 25 (Bloomberg) -- People with tuberculosis that is resistant to most antibiotics may be treatable with more aggressive use of the medicines at hand, Harvard researchers said.
The findings may help prevent the most infectious form of the disease from flourishing by stemming the spread of resistance, according to a study published in The Lancet.
Tests at prisons in Tomsk, Russia, where drug-resistant tuberculosis is rife, showed that the most vulnerable patients responded to a combination of treatment with five of the most effective anti-tuberculosis drugs and two less effective ones. About half of patients with the most drug-resistant form of the infection and 67 percent of those who were susceptible to some medicines completed therapy or were cured.
``Aggressive management of this infectious disease is feasible and can prevent high mortality rates and further transmission of drug-resistant strains,'' said Salmaan Keshavjee, a doctor at Harvard Medical School in Boston, Massachusetts.
About 2 billion people, or 33 percent of the world's population, may be infected with Mycobacterium tuberculosis, the bug that causes tuberculosis. Half a million of those develop a type of the chronic bacterial infection that is resistant to the most commonly used antibiotics, Keshavjee said.
Tuberculosis is spread through the air and usually infects the lungs. Most infected people harbor the disease without symptoms. About 8 million people worldwide develop active tuberculosis and almost 2 million die every year, according to the World Health Organization.
First-Choice Treatments
Keshavjee's team looked at 608 patients with multidrug- resistant tuberculosis, caused by strains that can't be killed by isoniazid and rifampin antibiotics, which are first-choice treatments. 29 of the patients had so-called extensively drug- resistant tuberculosis, where the strains also don't respond to fluoroquinolone and injectable antibiotics such as amikacin, kanamycin or capreomycin.
None of the patients with the most aggressive form of the disease were infected with HIV, the virus that causes AIDS, and only 1 percent of those with the less aggressive form had the virus. Tuberculosis is a major cause of death for people living with HIV.
``Although we should be cautious in our hope to attain such success rates in settings with a high prevalence of HIV, aggressive treatment is the logical strategy to provide the best chance of cure while avoiding the creation of additional drug resistance,'' said Helen Cox and Cheryl McDermid from Médicins Sans Frontières in Cape Town in a comment.
The Bill and Melinda Gates Foundation and the Eli Lilly Foundation were among groups that sponsored the research.
To contact the reporter on this story: Chantal Britt at cbritt@bloomberg.net.
Last Updated: August 25, 2008
http://www.bloomberg.com/apps/news?pid=20601116&sid=aEUQPe6a4_dY&refer=africa
By Chantal Britt
Aug. 25 (Bloomberg) -- People with tuberculosis that is resistant to most antibiotics may be treatable with more aggressive use of the medicines at hand, Harvard researchers said.
The findings may help prevent the most infectious form of the disease from flourishing by stemming the spread of resistance, according to a study published in The Lancet.
Tests at prisons in Tomsk, Russia, where drug-resistant tuberculosis is rife, showed that the most vulnerable patients responded to a combination of treatment with five of the most effective anti-tuberculosis drugs and two less effective ones. About half of patients with the most drug-resistant form of the infection and 67 percent of those who were susceptible to some medicines completed therapy or were cured.
``Aggressive management of this infectious disease is feasible and can prevent high mortality rates and further transmission of drug-resistant strains,'' said Salmaan Keshavjee, a doctor at Harvard Medical School in Boston, Massachusetts.
About 2 billion people, or 33 percent of the world's population, may be infected with Mycobacterium tuberculosis, the bug that causes tuberculosis. Half a million of those develop a type of the chronic bacterial infection that is resistant to the most commonly used antibiotics, Keshavjee said.
Tuberculosis is spread through the air and usually infects the lungs. Most infected people harbor the disease without symptoms. About 8 million people worldwide develop active tuberculosis and almost 2 million die every year, according to the World Health Organization.
First-Choice Treatments
Keshavjee's team looked at 608 patients with multidrug- resistant tuberculosis, caused by strains that can't be killed by isoniazid and rifampin antibiotics, which are first-choice treatments. 29 of the patients had so-called extensively drug- resistant tuberculosis, where the strains also don't respond to fluoroquinolone and injectable antibiotics such as amikacin, kanamycin or capreomycin.
None of the patients with the most aggressive form of the disease were infected with HIV, the virus that causes AIDS, and only 1 percent of those with the less aggressive form had the virus. Tuberculosis is a major cause of death for people living with HIV.
``Although we should be cautious in our hope to attain such success rates in settings with a high prevalence of HIV, aggressive treatment is the logical strategy to provide the best chance of cure while avoiding the creation of additional drug resistance,'' said Helen Cox and Cheryl McDermid from Médicins Sans Frontières in Cape Town in a comment.
The Bill and Melinda Gates Foundation and the Eli Lilly Foundation were among groups that sponsored the research.
To contact the reporter on this story: Chantal Britt at cbritt@bloomberg.net.
Last Updated: August 25, 2008
http://www.bloomberg.com/apps/news?pid=20601116&sid=aEUQPe6a4_dY&refer=africa