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Global problems
P2-370 Weight variation over time and its association with tuberculosis treatment outcome: a longitudinal analysis
  1. A Bernabe-Ortiz1,
  2. C Carcamo1,
  3. J Sanchez2,
  4. J Rios3
  1. 1Universidad Peruana Cayetano Heredia, Lima, Peru
  2. 2US Naval Medical Research Unit No 6, Lima, Peru
  3. 3Ministry of Health, Lima, Peru

Abstract

Introduction Tuberculosis (TB) is a wasting disease. Weight variation has been proposed as a marker to predict TB therapy outcome. The goal of this study was to evaluate trends of patients' bodyweight over time depending upon TB treatment outcome.

Methods A retrospective cohort study with TB cases diagnosed from 2000 to 2006 was performed. Information from five public treatment facilities at San Juan de Miraflores, Lima, Peru was collected. Poor outcome was defined as failure or death during therapy, and compared to good outcome defined as cured. Longitudinal analysis using a marginal model was fitted using Generalised Estimating Equations to compare weight trends for patients with good and poor outcome, adjusting for age, sex, tuberculosis type, treatment scheme, BCG scar presence, HIV status and sputum variation during follow-up.

Results A total of 460 patients (55.4% males) were included: 42 (9.1%) had a poor outcome (17 failed and 25 died). Weight at baseline was not different between outcome groups. Interaction terms between outcome status and time were significant (p=0.002) indicating that trends of bodyweight of patients with poor outcome completely differed of those with good outcome during follow-up. This divergence was observed from the first month of therapy (coefficient −2.54, p<0.001) and was markedly different at fourth month of treatment (coefficient −4.08, p=0.003).

Conclusion Weight variation during tuberculosis therapy follow-up can predict treatment outcome. Patients with weigh loss during therapy or without gaining appropriate weight during treatment should be more closely followed as they are at risk of failure or death.

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