马拉维条件下方案中同时应用奈韦拉平与利福平治疗的结局和安全性。

Outcomes and safety of concomitant nevirapine and rifampicin treatment under programme conditions in Malawi.

机构信息

Médecins sans Frontières, Thyolo District, Thyolo, Malawi.

出版信息

Int J Tuberc Lung Dis. 2010 Feb;14(2):197-202.

PMID:20074411

Abstract

SETTING

Thyolo District Hospital, rural Malawi.

OBJECTIVES

To report on 1) clinical, immunological and virological outcomes and 2) safety among human immunodeficiency virus (HIV) infected patients with tuberculosis (TB) who received concurrent nevirapine (NVP) and rifampicin (RMP) based treatment.

DESIGN

Retrospective cohort study.

METHODS

Analysis of programme data, June-December 2007.

RESULTS

Of a total of 156 HIV-infected TB patients who started NVP-based antiretroviral treatment, 136 (87%) completed TB treatment successfully, 16 (10%) died and 5 (4%) were transferred out. Mean body weight and CD4 gain (adults) were respectively 4.4 kg (95%CI 3.3-5.4) and 140 cells/mm(3) (95%CI 117-162). Seventy-four per cent of patients who completed TB treatment and had a viral load performed (n = 74) had undetectable levels (<50 copies/ml), while 17 (22%) had a viral load of 50-1000 copies/ml. Hepatotoxicity was present in 2 (1.3%) patients at baseline. Two patients developed Grade 2 and one developed Grade 3 alanine transaminase enzyme elevations during TB treatment (incidence rate per 10 years of follow-up 4.2, 95%CI 1.4-13.1). There were no reported deaths linked to hepatotoxicity.

CONCLUSIONS

In a rural district in Malawi, concomitant NVP and RMP treatment is associated with good TB treatment outcomes and appears safe. Further follow-up of patients would be useful to ascertain the longer-term effects of this concurrent treatment.

摘要

背景

马拉维农村地区的蒂约罗区医院。

目的

报告 1）临床、免疫学和病毒学结果和 2）同时接受奈韦拉平（NVP）和利福平（RMP）为基础治疗的艾滋病毒（HIV）感染肺结核（TB）患者的安全性。

设计

回顾性队列研究。

方法

对 2007 年 6 月至 12 月期间的项目数据进行分析。

结果

共 156 名开始 NVP 为基础抗逆转录病毒治疗的 HIV 感染 TB 患者中，136 名（87％）成功完成 TB 治疗，16 名（10％）死亡，5 名（4％）转出。平均体重和 CD4 增加（成人）分别为 4.4 公斤（95％CI 3.3-5.4）和 140 个细胞/mm³（95％CI 117-162）。完成 TB 治疗且进行病毒载量检测的 74 名患者中（n = 74），有 74 名（74％）病毒载量不可检测（<50 拷贝/ml），17 名（22％）病毒载量为 50-1000 拷贝/ml。基线时有 2 名（1.3％）患者存在肝毒性。在 TB 治疗期间，有 2 名患者发生 2 级和 1 名患者发生 3 级丙氨酸转氨酶升高（每 10 年随访发生率为 4.2，95％CI 1.4-13.1）。没有报告与肝毒性相关的死亡。