Study says extensive drug resistant TB still curable

By Gene Emery

BOSTON (Reuters) - Tuberculosis resistant to most drugs can still be cured in 60 percent of cases using aggressive treatment with at least five drugs, doctors reported on Wednesday.

They said their finding offers hope for people with extensively drug-resistant TB or XDR-TB, an infection that is not stopped by two first-line drugs used to treat the disease, along with three of the six classes of second-line drugs.

"It's essential that the world know that XDR-TB is not a death sentence," said Carole Mitnick of Harvard Medical School in Boston, who led the study.

"As or even more importantly, our study shows that effective treatment does not require hospitalization or indefinite confinement of patients," Mitnick said in a statement.

The researchers started with 650 patients in Lima, Peru, who had drug-resistant TB. Of them 48 had XDR-TB and none were infected with the AIDS virus, a complication that makes such TB virtually untreatable.

Doctors offered patients free individualized treatment with at least five drugs given simultaneously, along with surgery to cut out clumps of badly infected tissue and nutritional and psychological support.

Sixty percent were cured by the end of the treatment compared to 66 percent of the 603 volunteers whose TB showed resistance to fewer drugs, Mitnick's team reported in the New England Journal of Medicine.

"Aggressive regimens -- with many drugs, at the highest tolerated doses -- were used to maximize the chemotherapeutic benefit," they wrote.