Lethal Risk Factors in Patients with Rifampicin Resistant Tuberculosis according to Federal Register of Tuberculosis Cases

The objective: to study the factors influencing the risk and timing of a lethal outcome in tuberculosis patients with confirmed resistance to rifampicin in general population (Federal Register of Tuberculosis Cases of the Russian Federation (FRTBC)). Subjects and Methods. 15,604 tuberculosis patients with confirmed resistance to at least rifampicin and registered for treatment in 2021 were enrolled in a retrospective cohort study of lethal outcome predictors in general population (Federal Register of Tuberculosis Cases of the Russian Federation (FRTBC)). Results. The leading lethal risk factors were as follows: positive HIV status (aOR=2.82; 95% CI 2.60-3.06), history of treatment interruption (aOR=1.90; 95% CI 1.67-2.15), and patient age (aOR=1.03; 95% CI 1.02-1.03). The lower risk of mortality was noted in female patients (aOR=0.76; 95% CI 0.69-0.83), patients susceptible to fluoroquinolones (aOR=0.77; 95% CI 0.71-0.85), and patients with tuberculosis relapse (aOR=0.85; 95% CI 0.75-0.97). The time to death was shorter in new tuberculosis patients, patients with no confirmed resistance to fluoroquinolone, and HIV positive patients not receiving antiretroviral therapy (ART). Conclusion. To reduce the risk of a lethal outcome in addition to early detection of tuberculosis, it is advisable to administer antiretroviral therapy in HIV positive patients in a timely manner, as well as to monitor the adequacy of anti-tuberculosis therapy prescribed and the patient's adherence to treatment.