TREATMENT OUTCOME AND ADVERSE EFFECT IN ELDERLY TUBERCULOSIS PATIENTS ACCORDING TO COMORBIDITIES

Seo Yun Kim, MD*, Ju-Seop Kang, MD, Sang-Min Lee, MD, Jae-Jun Yim, MD, ChulGyu Yoo, MD, Young Whan Kim, MD, Sung Koo Han, MD, Young-Soo Shim, MD and Seok-Chul Yang, MD
Seoul National University, Seoul, South Korea

PURPOSE: 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. METHODS: 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 nonimmunocompromised 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). RESULTS: 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). CONCLUSION: 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. CLINICAL IMPLICATIONS: The present study suggests immune-compromising comorbidities in elderly are not an obstacle to tuberculosis treatment. DISCLOSURE: Seo Yun Kim, No Financial Disclosure Information; No Product/Research Disclosure Information