पल्मोनरी एवं श्वसन चिकित्सा

Prospective Study of Moxifloxacin prophylaxis in Patients Suffering with HIV Having Contact History of Multidrug Resistant Tuberculosis (MDR-TB)

Abstract

Kalyan Kumar PV, Ramakrishna Gorantla and Ramakrishna Rachakonda

Aim and Objectives: To find out the effectiveness of moxifloxacin prophylaxis in HIV patients having contact history of MDR-TB. Materials and Methods: This is an observational prospective cohort study of HIV patients divided in to two groups, moxifloxacin prophylaxis group and non-prophylaxis group. These groups are followed for four years from March 2012 to March 2016 to appraise the incidence of tuberculosis and mortality in these two cohorts. Results: The tuberculosis incidence in more in non-prophylaxis group when compared to prophylaxis group. Crude tuberculosis incidence is 275 per 1000 person/years in non-prophylaxis group when compared to 42 per 1000 person/years in prophylaxis group (p<0.005). Incidence of MDR-TB is more in non-prophylaxis group (26 vs 6; p=0.002) when compared to prophylaxis group. Crude mortality rate is more in non-prophylaxis group (774 vs 103; p=0.003) when compared to the other group which was further confirmed by Cox regression hazards model. Proportional hazards model in which moxifloxacin prophylaxis had a 60% decrease in mortality compared to non-prophylaxis (adjusted relative hazard). Conclusion: Prophylaxis with 6-months moxifloxacin is an effective alternative for HIV patients instead of isoniazid suspected to contact with multidrug resistant tuberculosis.