Incidence and risk factors of serious adverse events during antituberculous treatment in Rwanda: a prospective cohort study

Autor: Osee Sebatunzi, J Clerinx, Jef Van den Ende, Natalie Lorent, Gloria Mukeshimana
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Bacterial Diseases
Male
HIV opportunistic infections
Pulmonology
Antitubercular Agents
lcsh:Medicine
HIV Infections
Kaplan-Meier Estimate
Risk Factors
Interquartile range
Medicine
Prospective Studies
Prospective cohort study
lcsh:Science
Multidisciplinary
Incidence
Incidence (epidemiology)
Hazard ratio
Lower Respiratory Tract Infections
Observational Studies
Coinfection
Infectious diseases
HIV clinical manifestations
Female
Research Article
Cohort study
Adult
Drugs and Devices
medicine.medical_specialty
Tuberculosis
Clinical Research Design
Viral diseases
Microbiology
Adverse Reactions
Virology
Internal medicine
Humans
Adverse effect
Biology
business.industry
lcsh:R
Rwanda
Tropical Diseases (Non-Neglected)
HIV
medicine.disease
Miliary Tuberculosis
Surgery
Co-Infections
Respiratory Infections
Multivariate Analysis
lcsh:Q
business
Follow-Up Studies
Zdroj: PLoS ONE, Vol 6, Iss 5, p e19566 (2011)
PLoS ONE
ISSN: 1932-6203
Popis: Background Tuberculosis (TB) and TB-human immunodeficiency virus infection (HIV) coinfection is a major public health concern in resource-limited settings. Although TB treatment is challenging in HIV-infected patients because of treatment interactions, immunopathological reactions, and concurrent infections, few prospective studies have addressed this in sub-Saharan Africa. In this study we aimed to determine incidence, causes of, and risk factors for serious adverse events among patients on first-line antituberculous treatment, as well as its impact on antituberculous treatment outcome. Methods and findings Prospective observational cohort study of adults treated for TB at the Internal Medicine department of the Kigali University Hospital from May 2008 through August 2009. Of 263 patients enrolled, 253 were retained for analysis: median age 35 (Interquartile range, IQR 28–40), 55% male, 66% HIV-positive with a median CD4 count 104 cells/mm3 (IQR 44–248 cells/mm3). Forty percent had pulmonary TB, 43% extrapulmonary TB and 17% a mixed form. Sixty-four (26%) developed a serious adverse event; 58/167 (35%) HIV-infected vs. 6/86 (7%) HIV-uninfected individuals. Commonest events were concurrent infection (n = 32), drug-induced hepatitis (n = 24) and paradoxical reactions/TB-IRIS (n = 23). HIV-infection (adjusted Hazard Ratio, aHR 3.4, 95% Confidence Interval, CI 1.4–8.7) and extrapulmonary TB (aHR 2, 95%CI 1.1–3.7) were associated with an increased risk of serious adverse events. For TB/HIV co-infected patients, extrapulmonary TB (aHR 2.0, 95%CI 1.1–3.9) and CD4 count
Databáze: OpenAIRE
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