Tuberculosis treatment outcomes of retreated pulmonary tuberculosis patients with isoniazid-resistant and rifampicin-resistant

Abstract Background About 8% of TB cases worldwide are estimated to have rifampicin-susceptible, isoniazid-resistant tuberculosis (Hr-TB), ranging from 5 to 11% regions. However, Hr-TB has not received much attention while comparing to be given high priority to the management of rifampicin-resistant tuberculosis (RR-TB). This study aimed to compare the differences of treatment effects for Hr-TB and RR-TB retreated pulmonary tuberculosis, so as to intensify the treatment and management of Hr-TB. Methods A retrospective study was used to collect bacteriologically positive retreated pulmonary tuberculosis patients with isoniazid-resistant and rifampicin-resistant, who were conducted at 29 tuberculosis control institutions in China from July 2009 to June 2021. We assessed effectiveness and safety of retreated pulmonary tuberculosis patients with isoniazid-resistant and rifampicin-resistant. Results A total of 147 with either positive smear or cultures were enrolled, and 80 cases were in Hr-TBgroup and 67 cases were in RR-TB group. There was no significant difference in terms of age, sex, body mass, type of retreatment and comorbid diabetes between the two groups ( P >0.05). There was no statistically significant difference ( P= 0.166) with regard to the treatment outcomes of the two groups, the cure rates were 54.7% (41/75) and 53.6% (30/56), respectively, and the failure rate in Hr- TB group 22.7% (17/75) was 10% higher than RR-TBgroup 10.7% (6/56). The rate of negative sputum smear at the end of the second month (65.7%) in the Hr-TB group was significantly lower than that in the RR-TB group (85.7%) ( P= 0.025). There were no significant differences in the incidences of serious adverse reactions and chest X-ray changes between the two groups ( P >0.05). During the 5-year follow-up, recurrence in the Hr-TB group (7 cases, 14.9%) was no significantly lower than that in the RR-TB group (4 cases, 11.8%) ( P =0.754). Conclusion The negative conversion rate and success rate of treatment in retreated Hr-TB patients were lower than RR-TB patients. The treatment outcomes of retreated Hr-TB patients with needs to improve and should receive the same level of attention as rifampicin resistance does.