Researchers from Texas found that
standard TB treatment rates may not be appropriate for all people;
What we found is that we're really using doses for very skinny people – 105 to 110 pounds. I haven't met many adults who are at that weight."
Implicit to this study is that there exists a quantity of inadequately treated TB patients. It has been well established that inadequate treatment leads to drug resistance and it has now
been found that co infection of drug resistant TB with HIV leads to increased TB infectiousness;
A small number of inadequately treated MDR TB patients coinfected with HIV were responsible for almost all TB transmission, and some patients were highly infectious.
The Peru study found that inadequate TB treatment was the critical factor to infectiousness;
although 97 HIV-positive patients with tuberculosis were admitted to the ward, just ten patients were responsible for virtually all the characterized cases of tuberculosis among the guinea pigs. Six of these patients had MDR tuberculosis that had been suboptimally treated.
..the three most infectious patients (all of whom had suboptimally treated MDR tuberculosis) produced 226, 52, and 40 quanta per hour
Given that the average was 8.2 quanta per hour these patients are extremely infectious
These findings show that a few inadequately treated HIV-positive patients with MDR tuberculosis caused nearly all the tuberculosis transmission
In serious cases TB treatment may need to be individually monitored and to that extent Quantiferon
was found to be useful
“our results support the candidature of QFT-G [QuantiFERON ® -TB Gold In-Tube] assay as a potential tool to monitor the efficacy of anti-tuberculosis treatment in cases of active PTB. Considering the continued rise of multidrug-resistant TB, our results suggest that QFT-G may be useful in the early detection of likely non-responders, with broader implications for designing individualized treatment.”
