A review of efficacy studies of 6-month short-course therapy for tuberculosis among patients infected with human immunodeficiency virus: Differences in study outcomes

Six-month regimens that include rifampin for the treatment of tuberculosis in patients without human immunodeficiency virus (HIV) infection are recomm ended because of low percentage of relapses. Whether a similar duration of therapy should be used to treat tuberculosis in HIV-infected patients is un clear. Six studies of patients with HIV-infection and 3 of patients without HIV infection were reviewed and compared. The studies differed in terms of design, eligibility criteria, site of disease, frequency of dosing, dose a dministration methods, and outcome definitions. Among HIV-infected patients , the following percentages were found: cure, 59.4%-97.1%; treatment succes s, 34.0%-100%; effective treatment, 29.4%-88.2%; and relapse, 0%-10%. In th ose without HIV infection, percentages were as follows: cure, 62.3%-88.0%; treatment success, 91.2%-98.8%; effective treatment, 70.6%-83.8%; and relap se, 0%-3.4%. Although the rate of relapse appeared to be higher in some stu dies of HIV-infected patients with tuberculosis, this review demonstrates t he limitation in the use of relapse as the exclusive outcome of interest wh en comparing studies.