Comorbidome in multidrug-resistant tuberculosis patients

<b>Background:</b> Treatment outcome and survival in multidrug-resistant tuberculosis (MDR-TB) patients depends on many factors including the spectrum and severity of comorbidities. The aim is to reveal the most significant comorbidities in MDR-TB patients. <b>Methods:</b> 148 HIV-negative MDR-TB pts (76.4% male, 18-78 y. o.; 79.1% re-treated cases; 62.2% XDR-TB) were treated accordingly WHO recommendations (2018) and followed for a median 104 wks. The frequency of comorbidities and their relationship with outcome were analyzed using Cox regression, with graphic presentation as a comorbidome. The Charlson comorbidity index was tested as a predictor of unsuccessful outcome and mortality. <b>Results:</b> comorbidities were revealed in 85.1% (126/148 pts); 68,9% have ≥2 concomitant diseases, predominantly chronic obstructive pulmonary disease COPD (43.2%), central nervous (30.7%) and ocular (29.6%) pathology. Risk factors of unsuccessful treatment outcome (in 41/148 pts, 21.4%) were COPD (OR 2.58, 95%CI 1.27-5.23), encephalopathy (ОR 2.40, 95% CI 1.18-4.89), cardiovascular disease (OR 2.38, 95% CI 1.11-5.13), age over 40 y.o (OR 2.33, 95% CI 1.15-4.70). The main predictors of mortality (5.2%, 10 pts) were cardiovascular disease (HR=7.16, 95% CI 1.79-28.70) and chronic kidney disease (HR=3.16, 95% CI 1.09-9.12); Charlson index &gt; 1 associated with an increase of mortality (p&lt;0.01). Comorbidome model was constructed. <b>Conclusion:</b> the most frequent comorbidities in MDR-TB patients with negative influence on treatment outcome are COPD, nervous and cardiovascular diseases; cardiovascular and chronic kidney diseases increase mortality risk. The Charlson index can be used to assess prognosis in MDR-TB pts.