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HIV与结核病合并感染患者中一线抗结核药物的不良事件

ADVERSE EVENTS TO FIRST LINE ANTI-TUBERCULOSIS DRUGS IN PATIENTS CO-INFECTED WITH HIV AND TUBERCULOSIS.

作者信息

Michael O S, Sogaolu O M, Fehintola F A, Ige O M, Falade C O

机构信息

Department of Pharmacology and Therapeutics, College of Medicine, University of Ibadan, Nigeria.

Chest Unit, Department of Medicine, College of Medicine, University of Ibadan, Nigeria.

出版信息

Ann Ib Postgrad Med. 2016 Jun;14(1):21-29.

Abstract

BACKGROUND

The combination and use of multiple drugs in the treatment of tuberculosis (TB) predispose to adverse drug events and reactions. This study evaluated the incidence, frequency, and severity of adverse events to first line anti-tuberculosis (anti-TB) drugs in patients with TB and co-infections with Human Immunodeficiency Virus (HIV).

OBJECTIVE

The objective of this study was to determine the effects of HIV status on the risk of developing adverse events to first line anti-TB therapy.

METHOD

The study was carried out between 2006 and 2007 when TB therapy was administered without concomitant anti-retroviral therapy. Patients with TB presenting at the chest clinic of a tertiary hospital were sequentially enrolled. Those with TB alone were allocated to the first group while those with TB-HIV infection were allocated to a second group. A checklist of adverse events to the drugs was used to screen for adverse drug events and reactions during the period of anti-TB therapy. Adverse drug events were graded as serious and others (mild-moderate).

RESULTS

One hundred and three patients completed the study. Thirty one (30.1%) of the patients had TB-HIV co-infection. Majority (70.4%) of the events were detected during the first week of therapy, 92% of these events were mild-moderate. Eight (25.5%) of those with TB-HIV co-infection had serious adverse events. All the serious events occurred in the TB-HIV group. Independent factors for occurrence of ADEs include HIV status, increasing age, and female gender.

CONCLUSION

The rate of adverse drug events among patients on first line antituberculosis treatment was higher in HIV co-infected patients.

摘要

背景

在结核病(TB)治疗中联合使用多种药物易引发药物不良事件和反应。本研究评估了结核病患者以及合并人类免疫缺陷病毒(HIV)感染患者中一线抗结核药物不良事件的发生率、发生频率和严重程度。

目的

本研究的目的是确定HIV感染状况对一线抗结核治疗发生不良事件风险的影响。

方法

该研究于2006年至2007年期间进行,当时结核病治疗未同时给予抗逆转录病毒治疗。在一家三级医院胸科门诊就诊的结核病患者被依次纳入研究。单纯结核病患者被分配到第一组,而结核病合并HIV感染患者被分配到第二组。使用药物不良事件清单在抗结核治疗期间筛查药物不良事件和反应。药物不良事件分为严重和其他(轻度至中度)。

结果

103名患者完成了研究。31名(30.1%)患者合并结核病和HIV感染。大多数不良事件(70.4%)在治疗的第一周被检测到,其中92%为轻度至中度。结核病合并HIV感染患者中有8名(25.5%)发生了严重不良事件。所有严重事件均发生在结核病合并HIV感染组。不良事件发生的独立因素包括HIV感染状况、年龄增加和女性性别。

结论

合并HIV感染的患者在接受一线抗结核治疗时发生药物不良事件的发生率更高。

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本文引用的文献

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Drug hypersensitivity reactions in patients with HIV disease.
Expert Rev Clin Immunol. 2007 May;3(3):395-410. doi: 10.1586/1744666X.3.3.395.
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Drug hypersensitivity in HIV.HIV中的药物超敏反应。
Curr Opin Allergy Clin Immunol. 2007 Aug;7(4):324-30. doi: 10.1097/ACI.0b013e32825ea68a.

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