MAVS-Mediated Apoptosis and Its Inhibition by Viral Proteins

Cesar A. Bonilla, Aldo Crossa, Hector O. Jave, Carole D. Mitnick, Ronal B. Jamanca, Cesar Herrera, Luis Asencios, Alberto Mendoza, Jaime Bayona, Matteo Zignol, Ernesto Jaramillo

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Aim: To describe the incidence of extensive drug-resistant tuberculosis (XDR-TB) reported in the Peruvian National multidrug-resistant tuberculosis (MDR-TB) registry over a period of more than ten years and present the treatment outcomes for a cohort of these patients. Methods: From the Peruvian MDR-TB registry we extracted all entries that were approved for second-line anti-TB treatment between January 1997 and June of 2007 and that had Drug Susceptibility Test (DST) results indicating resistance to both rifampicin and isoniazid (i.e. MDR-TB) in addition to results for at least one fluoroquinolone and one second-line injectable (amikacin, capreomycin and kanamycin). Results: Of 1,989 confirmed MDR-TB cases with second-line DSTs, 119(6.0%) XDR-TB cases were detected between January 1997 and June of 2007. Lima and its metropolitan area account for 91% of cases, a distribution statistically similar to that of MDR-TB. A total of 43 XDR-TB cases were included in the cohort analysis, 37 of them received ITR. Of these, 17(46%) were cured, 8(22%) died and 11(30%) either failed or defaulted treatment. Of the 14 XDR-TB patients diagnosed as such before ITR treatment initiation, 10 (71%) were cured and the median conversion time was 2 months. Conclusion: In the Peruvian context, with long experience in treating MDR-TB and low HIV burden, although the overall cure rate was poor, a large proportion of XDR-TB patients can be cured if DST to second-line drugs is performed early and treatment is delivered according to the WHO Guidelines. © 2008 Bonilla et al.
Original languageAmerican English
JournalPLoS ONE
StatePublished - 5 Apr 2013
Externally publishedYes

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    Bonilla, C. A., Crossa, A., Jave, H. O., Mitnick, C. D., Jamanca, R. B., Herrera, C., Asencios, L., Mendoza, A., Bayona, J., Zignol, M., & Jaramillo, E. (2013). MAVS-Mediated Apoptosis and Its Inhibition by Viral Proteins. PLoS ONE.