From near death, TB patient with HIV bounces back

Once an active case of extremely drug-resistant (XXDR-TB) strain of tuberculosis or totally drug resistant (TDR) TB, Rashid Khan (name changed) has come a long way in the last two years. Rashid, 39, was one of the first XXDR-TB patients and is also the only patient with an HIV co-infection reported by chest physician from Hinduja Hospital Dr Zarir Udwadia.

From a frail patient who could barely get out of the cot in his 100 sq ft shanty in Dharavi, Rashid often required oxygen support. Today, he sits up in his home to recount his ordeal. Rashid has recovered fairly well from XXDR-TB.

"I was in the jaws of death two years ago. Almost no drug regimen for TB was effective to cure my ailment," he told dna.

While browsing through Rashid's medical papers, a footnote written by Dr Udwadia to NGO, 'Médecins Sans Frontières' – or Doctors Without Borders – becomes starkly apparent. It reads: 'Let us not give up on him without a final fight'.

As Rashid reads the footnote, his eyes become misty. "The final fight has paid off," he says. Last year, Rashid was put on Bedaquiline, an anti-leprosy drug, for close to six months. "There was a faint hope that it could cure my XXDR-TB infection. I consumed the drug along with a daily regimen of another four to eight medicines and injections as guided by Hinduja Hospital and experts from the NGO. I had severe hot flashes and turned insomniac for months. My cardiac health and hearing capacity was checked every fifteen days," he said.

Since the last fifteen months, Rashid has continuously tested negative for XXDR-TB.

An emotional Rashid said that Dr Udwadia never gave up on him. "Dr Udwadia fed me sweets when I tested negative for XXDR-TB. He has been very positive all along. He encouraged me to live," said Rashid.

After Hinduja Hospital reported 12 XXDR-TB cases in 2012, more have been added to the pool till date. "Out of the 17 patients, he is one of the nine who have almost been cured of the dreaded XXDR-TB bacteria. While 30 such patients were treated over the last two years, 10 died," said Dr Udwadia.

Rashid came to Mumbai in the '90s. Having suffered from TB in 1991, he fell prey to it again in 2007 and took treatment from a private doctor before being referred to Hinduja hospital. In December 2012, he underwent a left lung removal surgery at Hinduja Hospital which cost him a Rs1.5 lakh. "I spend Rs1,200 daily for medicines since surgery, fifty per cent of which is reimbursed by donations from NGOs. With Sion hospital having turned me away for reasons unknown in 2007 when I first approached them for TB treatment, I had to rely on private doctors for surgery," he says.

In spite of testing negative, Rashid still has to continue with anti-TB drugs and anti-HIV medicines, he says. "I contract pneumonia and cough at times, my white blood cell count has dipped to 194 while the normal is 350."

Of 12 cases reported by Dr Udwadia, he says the first XXDR-TB case is from Dharavi where the population is 25lakh in an area of 1.75 sq km. He said Dharavi has the highest number of people living within 1.75sq km compared to anywhere else in the world, making them more vulnerable.