与HAART/抗结核联合治疗相关的肝毒性风险:埃塞俄比亚中部转诊医院的病例对照研究

M. Woldu, H. Getaneh, J. Lenjisa, Gobezie Temesgen Tegegn, G. Umeta, Hunduma Dinsa Ayano
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引用次数: 0

摘要

背景:肝毒性历来是ART毒性相关停药的第三大常见原因。肝毒性导致就医、工作计划检查和频繁住院,所有这些都增加了费用。本研究的目的是确定肝毒性的风险,并确定在研究地点可能导致肝毒性的主要预测因素。方法:对105例TB/HIV合并感染病例进行病例对照研究。结果:在纳入研究的105例患者中,21例(20%)发生肝毒性。女性54人(51.43%)。患者CD4细胞计数平均值为205.1 + 96.18 cells/μL,最低为51cells/ μL,最高为559cells/ μL。最常见的抗结核方案是2(INH, RIF, ETM, PZA)/4(INH, RIF)。95名(90.5%)参与者使用主要预防药物。其中49例(46.7%)使用复方新诺明。女性发生肝毒性12例(57.1%)。大多数出现肝毒性的患者处于HIV/AIDS进展的第三阶段。社会药物使用与肝毒性的发生显著相关(P= 0.005), 95% CI(0.01-311)。与D4T/3TC/EFV方案的患者相比,TDF/3TC/EFV方案的患者(OR= 121.7, P= 0.010)和D4T/3TC/NVP方案的患者(OR= 47.4, P= 0.009)更容易发生肝毒性。同样,采用2(ERHZ)/4(RH)抗结核方案的患者(OR= 575.96, P= 0.002), 95% CI(0.02-3.8),发现与其他类型的抗结核方案相比,更容易发生肝毒性。结论:根据本研究结果,TB/HIV合并感染患者的肝毒性风险可能是由多种因素引起的,其中性别、WHO临床分期、社会药物的使用、ART治疗方案类型和抗结核治疗方案类型是主要因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Risk of Hepatotoxicity Associated with HAART/Anti-Tb Co-Treatment: A Case Control Study in a Central Ethiopian Referral Hospital
Background: Hepatotoxicity is historically the 3rd most common reason for ART toxicity related discontinuation. Liver toxicity leads to medical visit, work plan exams, and frequent hospital admissions all of which increases expenses. The objective of this study was to determine the risk of hepatotoxicity and identify the major predictors that may cause hepatotoxicity in the study place. Methods: A case-control study was done by reviewing a total of 105 TB/HIV co- infected patients' charts. Results: Of the total 105 patients included in the study, 21 (20%) developed hepatotoxicity. Fifty four (51.43%) of the participants were females. The mean CD4 count of the patients was 205.1 + 96.18 cells/μL and ranged from the lowest count of 51cells/μl to the highest recorded count of 559cells/μl. The most frequent anti-TB regimen prescribed was 2(INH, RIF, ETM, PZA)/4(INH, RIF). Ninety five (90.5%) of the participants were on the primarily prophylactic drugs. Of this figure, 49 (46.7%) were on cotrimoxazole. Number of female patients developed hepatotoxicity were 12 (57.1%). Most of the patients who had developed hepatotoxicity were in stage 3 of HIV/AIDS progression. Social drug use was significantly associated with development of hepatotoxicity (P=.005) with a 95% CI (0.01-311). Patients on TDF/3TC/EFV (OR= 121.7, P=.010) and D4T/3TC/NVP (OR= 47.4, P=.009) ART regimen were found to be more likely to develop hepatotoxicity compared to patients on D4T/3TC/EFV regimen. Similarly patients on 2(ERHZ)/4(RH) anti-TB regimen (OR= 575.96, P=.002) with a 95% CI (0.02-3.8), was found to be more likely to develop hepatotoxicity compared to the other types anti-Tb regimens. Conclusions: The risk of hepatotoxicity in TB/HIV coinfected patients can be due to a number of factors among which sex, the WHO clinical staging, use of Social drugs, type of ART regimen and type of anti-TB regimen are the major, according to the findings of this study.
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