*Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY †Philanjalo and Church of Scotland Hospital, Tugela Ferry, South Africa ‡Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa §Department of Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY ‖Health Systems Research Unit, Medical Research Council, Cape Town, South Africa ¶Department of Medicine, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa; Departments of #Medicine and **Epidemiology, Yale University School of Medicine, New Haven, CT ††Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA.
J Acquir Immune Defic Syndr. 2013 Apr 1;62(4):436-40. doi: 10.1097/QAI.0b013e31828175ed.
Most patients with multidrug-resistant tuberculosis (MDR-TB) in South Africa are HIV-infected, but the safety and tolerability of cotreatment are unknown. The authors reviewed all adverse events (AEs) for patients with MDR-TB in a home-based treatment program in rural KwaZulu-Natal. Of 91 MDR-TB patients, 74 (81%) were HIV-positive and receiving antiretroviral therapy. AEs were common, but most were mild and did not require therapy modification. The most common severe AEs were hypothyroidism (36%) and psychosis (5%). Patients receiving concurrent antiretroviral therapy did not experience AEs more frequently than those on MDR-TB therapy alone. Concurrent treatment for MDR-TB/HIV can be safely administered in a home-based care setting.
南非大多数耐多药结核病（MDR-TB）患者感染了 HIV，但联合治疗的安全性和耐受性尚不清楚。作者回顾了夸祖鲁-纳塔尔省农村地区一项家庭治疗方案中 MDR-TB 患者的所有不良事件（AE）。91 例 MDR-TB 患者中，74 例（81%）HIV 阳性并接受抗逆转录病毒治疗。AE 很常见，但大多数为轻度，无需调整治疗。最常见的严重 AE 是甲状腺功能减退（36%）和精神病（5%）。同时接受抗逆转录病毒治疗的患者与单独接受 MDR-TB 治疗的患者相比，AE 发生率并无差异。在家庭护理环境中，同时治疗 MDR-TB/HIV 是安全的。
