Incidence of and risk factors for severe liver toxicity in HIV-infected patients on anti-tuberculosis treatment
| Autor: | Pukenyte , E., Lescure , F. X., Rey , D., Rabaud , C., Hoen , B., Chavanet , P., Laiskonis , A. P., Schmit , J. L., May , T., Mouton , Y., Yazdanpanah , Y. |
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| Přispěvatelé: | Entente Interdépartementale pour la Démoustication, Région Rhône-Alpes, Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Lille - Economie et Management ( LEM ), Université catholique de Lille ( UCL ) -Université de Lille-Centre National de la Recherche Scientifique ( CNRS ) |
| Jazyk: | angličtina |
| Rok vydání: | 2007 |
| Předmět: |
MESH : AIDS-Related Opportunistic Infections
MESH : Liver Function Tests MESH : Retrospective Studies MESH : Tuberculosis Pulmonary MESH : Male MESH : Anti-HIV Agents MESH : Humans MESH : Adult MESH : Antitubercular Agents MESH : Proportional Hazards Models MESH : Risk Factors MESH : Incidence [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases MESH : Drug-Induced Liver Injury MESH : Regression Analysis MESH : Female MESH : Middle Aged MESH : France |
| Zdroj: | International Journal of Tuberculosis and Lung Disease International Journal of Tuberculosis and Lung Disease, International Union Against Tuberculosis and Lung Disease, 2007, 11 (1), pp.78-84 |
| ISSN: | 1027-3719 1815-7920 |
| Popis: | International audience; OBJECTIVE: To assess the incidence and risk factors for severe liver toxicity in human immunodeficiency virus (HIV) infected patients on anti-tuberculosis treatment and the impact of patients' characteristics and concomitant medications instituted during the first week of antituberculosis treatment. METHODS: HIV-infected patients referred to six French hospitals between 1 January 1992 and 31 December 2004, with confirmed or 'presumptive' tuberculosis (TB). Liver toxicity was studied during the first 2 months of TB treatment. RESULTS: During the 12 years of the study period, 144 patients were enrolled. Severe liver toxicity developed in 15 (10.7%). The median time to development of liver toxicity was 14 days. In the univariate analysis, high baseline bilirubin levels (P = 0.004), CD4 cell counts between 50 and 100 cells/mm3 (P = 0.022) and the use of fluconazole (P = 0.0005) were associated with liver toxicity. In the multivariate analysis, independent risk factors were abnormal baseline alanine aminotransferase (ALT) (P = 0.028) and bilirubin levels (P = 0.033) and the use of fluconazole (P = 0.008). CONCLUSION: Severe liver toxicity is frequent, and occurs early in the course of anti-tuberculosis treatment. ALT and bilirubin levels should be closely monitored during the first month of treatment, especially in patients with high baseline ALT or bilirubin levels. We suggest caution when prescribing fluconazole and anti-tuberculosis drugs concomitantly, although this needs to be confirmed and further investigated. |
| Databáze: | OpenAIRE |
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