Table 1

Studies regarding impact of dosing intermittency on treatment efficacy in HIV-related tuberculosis

Authors, year of publicationMeasures of treatment efficacySource of study materialsStudy designMain findingsStrengthsWeaknessesRisk of bias
Khan et al, 201031Failure, relapseMultiple countriesSystematic review and meta-analysis*Compared with partially intermittent treatment with daily initial phase, thrice-weekly treatment throughout was associated with higher rates of failure (adjusted RR 4.0, 95% CI 1.5 to 10.4) and relapse (adjusted RR 4.8, 95% CI 1.8 to 12.8).The study clearly addressed a focused question with good coverage on methodology and assessment of study quality. Literature search was sufficiently rigorous.There was considerable heterogeneity across studies.Low
Nahid et al, 200732RelapseUSARetrospective cohort analysisCompared with daily treatment, intermittent treatment was associated with relapse (adjusted HR 4.12, 95% CI 1.09 to 15.6).The study clearly addressed a focused question in a well-defined cohort with well-covered comparison between participants and those lost to follow-up. Outcomes were clearly defined with reliable assessment of exposure. Main potential confounders were considered. CIs were provided.Assessment of outcome was not blind.Low
Li et al, 200533Relapse, acquired rifamycin resistanceUSARetrospective cohort analysisIntermittent compared with daily treatment in the initial phase significantly increased the risk of relapse and acquired rifamycin resistance (HR for relapse 6.7, 95% CI 1.1 to 40.1; HR for acquired rifamycin resistance 6.4, 95% CI 1.1 to 38.4).The study clearly addressed a focused question in a well-defined cohort. Outcomes were clearly defined, with reliable assessment of exposure. Main potential confounders were considered. CIs were provided.Assessment of outcome was not blind. No comparison was made between participants and those lost to follow-up.Low

  • ↵* Articles identified by the literature search and included in systematic reviews identified by the current review are shown in appendix 3 in the online supplement.