Portal de Periódicos da CAPES

Factors That Complicate the Treatment of Tuberculosis in HIV-Infected Patients

2005; Lippincott Williams & Wilkins; Volume: 39; Issue: 4 Linguagem: Inglês

10.1097/01.qai.0000152400.36723.85

1944-7884

Mark S. Dworkin, Michael Adams, David L. Cohn, Arthur J. Davidson, Susan E. Buskin, Carrie Horwitch, Anne Morse, Judy Sackoff, Melanie Thompson, Linda L. Wotring, Scott B. McCombs, Jeffrey L. Jones,

HIV/AIDS drug development and treatment

Treatment of tuberculosis (TB) in persons coinfected with HIV has become increasingly complex during the past decade. We describe the factors that complicate anti-TB therapy in a large observational cohort of HIV-infected persons in the United States. Among 367 HIV-infected patients with 372 episodes of culture-confirmed TB, 44.1% had injection drug use as a mode of HIV transmission. Hepatic disease was present at the time of TB diagnosis or during anti-TB therapy for 91 episodes (24.5%). Elevation at least twice the upper limits of normal of aminotransaminases was observed during the first month of anti-TB therapy in 116 (31.2%) of the episodes. The most commonly reported adverse effects occurring during therapy were rash (27.8%), nausea (26.2%), leukopenia or neutropenia (20.2%), diarrhea (19.3%), vomiting (18.5%), and elevated temperature (>101.5 degrees F [38.6 degrees C], 16.9%). Prescription of a rifamycin and a medication known to interact with rifamycins occurred during 270 (72.6%) episodes. Because HIV-infected patients with TB often have underlying complicating conditions, such as hepatic disease, and are treated with medications that may have toxicities and cause drug-drug interactions, we recommend that clinicians pay careful attention to these factors when treating coinfected patients.