Hepatotoxicity induced by antituberculosis drugs among patients coinfected with HIV and tuberculosis

Abstract

Hepatotoxicity due to antituberculosis drugs limits treatment in patients coinfected with HIV and tuberculosis. We conducted a case-control study to identify risk factors for hepatotoxicity among patients coinfected with tuberculosis and HIV in two hospitals in Recife, Pernambuco State, Brazil. The sample consisted of 57 patients (36.5% of the total) who developed hepatotoxicity and a control group of 99 patients (63.5% of the total), who did not present this effect. Hepatotoxicity consisted of jaundice or a high concentration of AST/ALT or total bilirubinemia. Multivariate logistic regression showed that a T CD4+ count of < 200 cells/mm(3) increased the risk of hepatotoxicity by a factor of 1.233 (p < 0.001) and that coinfection with hepatitis B or C virus increased this risk by a factor of 18.187 (p = 0.029). Discharge occurred among 66.1% of the case group (p = 0.026). The absence of hepatotoxicity was a protective factor against death (OR = 0.42; 95%CI: 0.20-0.91). Coinfection with the B and C hepatitis virus and a T CD4+ cell count below 200 cells/mm(3) were independent risk factors for hepatotoxicity in these patients.

Anti-Tuberculosis Drug Induced Hepatotoxicity among TB/HIV Co-Infected Patients at Jimma University Hospital, Ethiopia: Nested Case-Control Study

“…Although it has been reported that women are more predisposed to the risk of anti-TB drugs induced hepatotoxicity, this study did not find any correlation between gender and hepatotoxicity, a finding which is in agreement with study by Pukenyte E, et al and Lima MFS, et al [20], [21].…”

“…The median time until the development of hepatotoxicity in TB/HIV co-infected patients was 14 days (range 4–60) as previous report by Pukenyte E, et al [20]. Study conducted in Brazil on hepatotoxicity due to anti-TB drugs in TB/HIV co-infected patients showed that more than 90% of hepatotoxicity occurred within the first 6 weeks of TB treatment [21]. The current finding is also in agreement with findings by Shakya R, et al who reported that the time interval for onset of hepatotoxicity after initiation of therapy was 12–60 days [17].…”

Hepatotoxicity and Associated Risk Factors in Hiv-Infected Patients Receiving Antiretroviral Therapy at Felege Hiwot Referral Hospital, Bahirdar, Ethiopia

“…This is probably because the courses of HIV pathogenesis and drug metabolism in humans generally are not sex dependent. This finding is similar with the findings of previous studies carried out in different countries such as Nigeria (6), Cameron (20), South Africa (21), Swiss (22) and Brazil (23). As found out in this study, age difference is not also a determinant factor for liver enzyme elevations.…”

Quantitative Real-Time PCR (Q-Pcr) for Sputum Smear Diagnosis of Pulmonary Tuberculosis Among People With Hiv/Aids

“…Due to the high frequency and severity of this coinfection, as well as the difficulty of arriving at a diagnosis with culture empirical treatment for TB is not uncommon in patients living with HIV/AIDS and respiratory symptoms. However, this conduct does not always prove beneficial, since coinfected patients present more adverse reactions to anti-TB drugs 3 . Moreover, there may be an interaction between the anti-TB drugs and antiretroviral therapy, which may impose limitations on the therapeutic response of these patients.…”