{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T13:25:22Z","timestamp":1787664322734,"version":"build-2736575974"},"reference-count":33,"publisher":"PAGEPress Publications","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Monaldi Arch Chest Dis"],"abstract":"<jats:p>Tuberculosis (TB) is commonly associated with significant weight loss, and weight gain during treatment is often considered an indicator of treatment response. However, evidence regarding the association between weight change and treatment outcomes among patients with extensively drug-resistant TB (XDR-TB) remains limited. This study aimed to evaluate the relationship between weight change during treatment and treatment outcomes among XDR-TB patients in Pakistan. A multicenter retrospective cohort study was conducted using data from XDR-TB patients treated at 27 Programmatic Management of Drug-Resistant TB units across Pakistan between May 2010 and June 2019. Patient data were extracted from the Electronic Nominal Recording and Reporting System of the National Tuberculosis Control Program. Weight change was assessed at 2, 4, and 6 months of treatment and categorized as no weight gain, weight gain &lt;4 kg, and \u22654 kg. Logistic regression analysis was performed to determine the association between weight gain and favorable treatment outcomes. A total of 255 XDR-TB patients were included in the final analysis. Among them, 54.9% were male, and the majority (52.2%) belonged to the 21-40 year age group. Overall, favorable treatment outcomes were observed in 54.9% of patients. In multivariate analysis, weight gain at the fourth month of treatment showed a statistically significant negative association with favorable treatment outcomes for both weight gain &lt;4 kg (OR 0.343, p=0.039) and \u22654 kg (OR 0.370, p=0.020). No statistically significant association was observed between weight gain at two or six months and treatment outcomes. These findings suggest that weight gain during treatment may not be a reliable predictor of favorable treatment outcomes among XDR-TB patients, and additional clinical and microbiological indicators should be considered when monitoring treatment response.<\/jats:p>","DOI":"10.4081\/monaldi.2026.4000","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T13:14:00Z","timestamp":1787663640000},"source":"Crossref","is-referenced-by-count":0,"title":["Association between\u00a0early weight variation and treatment outcomes among extensively drug-resistant tuberculosis patients in Pakistan: a multicenter retrospective cohort study"],"prefix":"10.4081","author":[{"given":"Muhammad","family":"Abubakar","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice, Faculty of Pharmacy, Salim Habib University, Korangi Creek, Karachi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javeria","family":"Sehar","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine and Physical Therapy, Xuzhou Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rimsha","family":"Mukhtar","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Faculty of Pharmacy, Hamdard University, Islamabad Campus, Islamabad"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"85664","doi-asserted-by":"crossref","unstructured":"Abubakar M, Ahmad N, Ghafoor A, et al. Treatment outcomes of extensively drug-resistant tuberculosis in pakistan: a countrywide retrospective record review. Front Pharmacol 2021;12:640555.","DOI":"10.3389\/fphar.2021.640555"},{"key":"85665","unstructured":"World Health Organization. Global tuberculosis report 2025. Available from: https:\/\/www.who.int\/teams\/global-programme-on-tuberculosis-and-lung-health\/tb-reports\/global-tuberculosis-report-2025."},{"key":"85666","unstructured":"Yirenkyi SO. The burden of extensively drug resistant and pre-extensively drug resistant tuberculosis among multidrug-resistant mycobacterium tuberculosis patients in Ghana. University of Ghana; 2022."},{"key":"85667","doi-asserted-by":"crossref","unstructured":"Abubakar M, Ahmad N, Atif M, et al. Prognostic accuracy of time to sputum culture conversion in predicting cure in extensively drug-resistant tuberculosis patients: a multicentre retrospective observational study. BMC Infect Dis 2022;22:204.","DOI":"10.1186\/s12879-022-07202-y"},{"key":"85668","doi-asserted-by":"crossref","unstructured":"Utpat KV, Rajpurohit R, Desai U. Prevalence of pre-extensively drug-resistant tuberculosis (Pre XDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) among extra pulmonary (EP) multidrug resistant tuberculosis (MDR-TB) at a tertiary care center in Mumbai in pre Bedaquiline (BDQ) era. Lung India 2023;40:19-23.","DOI":"10.4103\/lungindia.lungindia_182_22"},{"key":"85669","doi-asserted-by":"crossref","unstructured":"Balinda IG, Sugrue DD, Ivers LC. More than malnutrition: a review of the relationship between food insecurity and tuberculosis. Open Forum Infect Dis 2019;6:ofz102.","DOI":"10.1093\/ofid\/ofz102"},{"key":"85670","doi-asserted-by":"crossref","unstructured":"Bernabe-Ortiz A, Carcamo CP, Sanchez JF, Rios J. Weight variation over time and its association with tuberculosis treatment outcome: a longitudinal analysis. 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Mayo Clin Proc 2016;91:482-95.","DOI":"10.1016\/j.mayocp.2016.01.014"},{"key":"85674","doi-asserted-by":"crossref","unstructured":"Wagnew F, Alene KA, Kelly M, Gray D. Impacts of body weight change on treatment outcomes in patients with multidrug-resistant tuberculosis in Northwest Ethiopia. Sci Rep 2024;14:508.","DOI":"10.1038\/s41598-023-51026-y"},{"key":"85675","doi-asserted-by":"crossref","unstructured":"Akhtar AM, Kanwal S, Majeed S, Majeed W. Weight variation increases the risk of death during the intensive phase of treatment among MDR-TB patients: a retrospective study. Pak J Med Sci 2023;39:1080-5.","DOI":"10.12669\/pjms.39.4.7025"},{"key":"85676","doi-asserted-by":"crossref","unstructured":"Yen YF, Tung FI, Ho BL, Lai YJ. Underweight increases the risk of early death in tuberculosis patients. Br J Nutr 2017;118:1052-60.","DOI":"10.1017\/S0007114517003166"},{"key":"85677","doi-asserted-by":"crossref","unstructured":"Castello FA, Sosa EJ, Campos J, et al. Genomic characterization of XDR Mycobacterium tuberculosis isolates in Argentina (2006\u20132015). BMC Infect Dis 2025;25:1602.","DOI":"10.1186\/s12879-025-11913-3"},{"key":"85678","unstructured":"World Health Organization. Global tuberculosis report 2023. Available from: https:\/\/www.who.int\/publications\/i\/item\/9789240083851."},{"key":"85679","doi-asserted-by":"crossref","unstructured":"Naz F, Ahmad N, Wahid A, et al. High rate of successful treatment outcomes among childhood rifampicin\/multidrug-resistant tuberculosis in Pakistan: a multicentre retrospective observational analysis. BMC Infect Dis 2021;21:1209.","DOI":"10.1186\/s12879-021-06935-6"},{"key":"85680","doi-asserted-by":"crossref","unstructured":"Ahmad N, Ahuja SD, Akkerman OW, et al. Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis. 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Risk factors of multidrug-resistant tuberculosis: A global systematic review and meta-analysis. J Infect 2018;77:469-78.","DOI":"10.1016\/j.jinf.2018.10.004"},{"key":"85685","doi-asserted-by":"crossref","unstructured":"Frank M, Adamashvili N, Lomtadze N, et al. Long-term follow-up reveals high posttreatment mortality rate among patients with extensively drug-resistant tuberculosis in the country of Georgia. Open Forum Infect Dis 2019;6:ofz152.","DOI":"10.1093\/ofid\/ofz152"},{"key":"85686","doi-asserted-by":"crossref","unstructured":"Kwon YongSoo KY, Kim YeeHyung KY, Suh GeeYoung SG, et al. Treatment outcomes for HIV-uninfected patients with multidrug-resistant and extensively drug-resistant tuberculosis. Clin Infect Dis 2008;47:496-502.","DOI":"10.1086\/590005"},{"key":"85687","doi-asserted-by":"crossref","unstructured":"Tabarsi P, Chitsaz E, Baghaei P, et al. 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Pyrazinamide resistance and pncA mutation profiles in multidrug resistant Mycobacterium tuberculosis. Infect Drug Resist 2022:4985-94.","DOI":"10.2147\/IDR.S368444"},{"key":"85695","doi-asserted-by":"crossref","unstructured":"Phan MN, Guy ES, Nickson RN, Kao CC. Predictors and patterns of weight gain during treatment for tuberculosis in the United States of America. Int J Infect Dis 2016;53:1-5.","DOI":"10.1016\/j.ijid.2016.09.006"},{"key":"85696","doi-asserted-by":"crossref","unstructured":"Barnwal RK, Gawande AV, Narlawar UW, Zurmure SA. Impact of anti-tubercular treatment on weight and symptoms of category I tuberculosis patients in an urban city of central India. 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