Adverse Events in an Integrated Home-Based Treatment Program for MDR-TB and HIV in KwaZulu-Natal, South Africa

• Type of Material: Article
• Authors: James C. M. Brust, Montefiore Medical Center; N. Sarita Shah, Emory University; Theo L. van der Merwe, Philanjalo; Sheila Bamber, Philanjalo; Yuming Ning, Montefiore Medical Center; Moonseong Heo, Albert Einstein College of Medicine; Anthony P. Moll, Philanjalo; Marian Loveday, University of KwaZulu-Natal; Umesh G. Lalloo, University of Kwazulu Natal; Gerald H. Friedland, Yale University; Neel Gandhi, Emory University
• Language: English
• Date: 2013-04-01
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: Copyright © 2012 by Lippincott Williams & Wilkins.
• Final Published Version (URL): http://dx.doi.org/10.1097/QAI.0b013e31828175ed
• Title of Journal or Parent Work: Journal of Acquired Immune Deficiency Syndromes
• ISSN: 1525-4135
• Volume: 62
• Issue: 4
• Start Page: 436
• End Page: 440
• Grant/Funding Information: All remaining authors have no funding or conflict to disclose.; GHF is also supported by the Doris Duke Charitable Foundation (2007018), the Gilead Foundation, and The Irene Diamond Fund (R05130).; NRG and NSS are both recipients of the Doris Duke Charitable Foundation Clinical Scientist Development Award (NRG 2007070, NSS 2007071).; Additional funding for the program was provided by the US President's Emergency Plan for AIDS Relief.; Statistical support was provided by the Center for AIDS Research at Albert Einstein College of Medicine/Montefiore Medical Center (P30 AI051519).; JCMB is supported by the National Institutes of Health (K23 AI083088).
• Keywords: Immunology; Infectious Diseases; side effects; COMMUNITY-BASED THERAPY; resource-limited settings; adverse events; MULTIDRUG-RESISTANT TUBERCULOSIS; Science & Technology; HIV; multidrug-resistant tuberculosis; HYPOTHYROIDISM; Life Sciences & Biomedicine
• Research Categories: Health Sciences, Immunology

Abstract

Most patients with multidrug-resistant tuberculosis (MDR-TB) in South Africa are HIV-infected, but the safety and tolerability of cotreatment are unknown. The authors reviewed all adverse events (AEs) for patients with MDR-TB in a home-based treatment program in rural KwaZulu-Natal. Of 91 MDR-TB patients, 74 (81%) were HIV-positive and receiving antiretroviral therapy. AEs were common, but most were mild and did not require therapy modification. The most common severe AEs were hypothyroidism (36%) and psychosis (5%). Patients receiving concurrent antiretroviral therapy did not experience AEs more frequently than those on MDR-TB therapy alone. Concurrent treatment for MDR-TB/HIV can be safely administered in a homebased care setting.