PMID- 31809360
OWN - NLM
STAT- MEDLINE
DCOM- 20200706
LR  - 20221005
IS  - 1944-7884 (Electronic)
IS  - 1525-4135 (Print)
IS  - 1525-4135 (Linking)
VI  - 83
IP  - 1
DP  - 2020 Jan 1
TI  - The Impact of Concurrent Antiretroviral Therapy and MDR-TB Treatment on Adverse 
      Events.
PG  - 47-55
LID - 10.1097/QAI.0000000000002190 [doi]
AB  - BACKGROUND: South Africa has among the highest incidence of multidrug-resistant 
      tuberculosis (MDR-TB) and more than 70% of patients are HIV co-infected. MDR-TB 
      treatment is associated with frequent adverse events (AEs). Although guidelines 
      recommend concurrent treatment of MDR-TB and HIV, safety data on concurrent 
      therapy are limited. METHODS: We conducted a prospective observational study of 
      MDR-TB patients with and without HIV-coinfection in South Africa between 2011 and 
      2015. Participants received standardized MDR-TB and HIV regimens. Participants 
      were followed monthly for the duration of MDR-TB therapy and screened for 
      clinical and laboratory AEs. Audiometry was performed monthly during the 
      intensive phase; color discrimination testing was performed every 2 months. 
      RESULTS: We enrolled 150 HIV-infected and 56 HIV-uninfected participants. Nearly 
      all experienced at least one clinical (93%) or laboratory (96%) AE. The most 
      common clinical AEs were peripheral neuropathy (50%) and difficulty sleeping 
      (48%); the most common laboratory AEs were hypokalemia (47%) and decreased 
      creatinine clearance (46%). Among 19 clinical and lab AEs examined, there were no 
      differences by HIV status, except for diarrhea (27% HIV-infected vs. 13% 
      HIV-uninfected, P = 0.03). Hearing loss was experienced by 72% of participants 
      (8% severe loss). Fourteen percent experienced color discrimination loss (4% 
      severe loss). There were no differences in frequency or severity of hearing or 
      vision loss by HIV status. CONCLUSIONS: AEs were common, but not more frequent or 
      severe among MDR-TB/HIV co-infected participants receiving concurrent 
      antiretroviral therapy. Given the favorable treatment outcomes associated with 
      concurrent treatment, antiretroviral therapy initiation should not be delayed in 
      MDR-TB patients with HIV-coinfection.
FAU - Smith, Jonathan P
AU  - Smith JP
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA.
FAU - Gandhi, Neel R
AU  - Gandhi NR
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA.
AD  - Emory School of Medicine, Emory University, Atlanta, GA.
FAU - Shah, N Sarita
AU  - Shah NS
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA.
AD  - Division of Global HIV and Tuberculosis, US Centers for Disease Control and 
      Prevention, Atlanta, GA.
FAU - Mlisana, Koleka
AU  - Mlisana K
AD  - University of KwaZulu-Natal, Durban, South Africa.
AD  - National Health Laboratory Services, Durban, South Africa.
FAU - Moodley, Pravi
AU  - Moodley P
AD  - University of KwaZulu-Natal, Durban, South Africa.
AD  - National Health Laboratory Services, Durban, South Africa.
FAU - Johnson, Brent A
AU  - Johnson BA
AD  - University of Rochester, Rochester, NY.
FAU - Allana, Salim
AU  - Allana S
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA.
FAU - Campbell, Angela
AU  - Campbell A
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA.
FAU - Nelson, Kristin N
AU  - Nelson KN
AD  - Department of Epidemiology, Rollins School of Public Health, Emory University, 
      Atlanta, GA.
FAU - Master, Iqbal
AU  - Master I
AD  - King Dinuzulu Hospital, Durban, South Africa; and.
FAU - Brust, James C M
AU  - Brust JCM
AD  - Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY.
LA  - eng
GR  - P30 AI050409/AI/NIAID NIH HHS/United States
GR  - UL1 TR002378/TR/NCATS NIH HHS/United States
GR  - R01 AI089349/AI/NIAID NIH HHS/United States
GR  - UL1 TR001073/TR/NCATS NIH HHS/United States
GR  - R01 AI087465/AI/NIAID NIH HHS/United States
GR  - U19 AI111211/AI/NIAID NIH HHS/United States
GR  - K24 AI114444/AI/NIAID NIH HHS/United States
GR  - R01 AI114304/AI/NIAID NIH HHS/United States
GR  - P30 AI124414/AI/NIAID NIH HHS/United States
GR  - UL1 TR002556/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - J Acquir Immune Defic Syndr
JT  - Journal of acquired immune deficiency syndromes (1999)
JID - 100892005
RN  - 0 (Anti-HIV Agents)
RN  - 0 (Antitubercular Agents)
SB  - IM
MH  - Adult
MH  - Anti-HIV Agents/*therapeutic use
MH  - Antitubercular Agents/*therapeutic use
MH  - Case-Control Studies
MH  - Female
MH  - HIV Infections/complications/*drug therapy
MH  - Humans
MH  - Male
MH  - Prospective Studies
MH  - Tuberculosis, Multidrug-Resistant/complications/*drug therapy
PMC - PMC6903405
MID - NIHMS1539839
EDAT- 2019/12/07 06:00
MHDA- 2020/07/07 06:00
PMCR- 2021/01/01
CRDT- 2019/12/07 06:00
PHST- 2019/12/07 06:00 [entrez]
PHST- 2019/12/07 06:00 [pubmed]
PHST- 2020/07/07 06:00 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 00126334-202001010-00007 [pii]
AID - 10.1097/QAI.0000000000002190 [doi]
PST - ppublish
SO  - J Acquir Immune Defic Syndr. 2020 Jan 1;83(1):47-55. doi: 
      10.1097/QAI.0000000000002190.