Hepatotoxicity induced by antituberculosis drugs among patients coinfected with HIV and tuberculosis
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Cadernos de Saúde Pública |
Texto Completo: | https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/4991 |
Resumo: | 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 < 200cells/mm³ 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 200cells/mm³ were independent risk factors for hepatotoxicity in these patients |
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Hepatotoxicity induced by antituberculosis drugs among patients coinfected with HIV and tuberculosisDrug ToxicityCoinfectionTuberculosisHIVHepatotoxicity 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 < 200cells/mm³ 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 200cells/mm³ were independent risk factors for hepatotoxicity in these patientsHepatotoxicidade secundária às drogas antituberculose limita o tratamento em pacientes coinfectados com HIV e tuberculose. Conduzimos estudo caso-controle para identificar fatores de risco para hepatotoxicidade entre pacientes com tuberculose e infecção pelo HIV em dois hospitais de Recife, Pernambuco, Brasil. O grupo caso consistiu de 57 (36,5%) pacientes com hepatotoxicidade e o grupo controle, 99 (63,5%) pacientes que não a apresentaram. Hepatotoxicidade foi definida como icterícia ou alta concentração de ALT/AST ou de bilirrubinemia total. Regressão logística multivariada mostrou que a contagem de linfócitos T CD4+ < 200 células/mm³ aumentou o risco de hepatotoxicidade em 1,233 vezes (p < 0,001), e coinfecção com vírus de hepatite B ou C aumentou o risco em 18,187 (p = 0,029). Alta hospitalar ocorreu em 66,1% dos pacientes do grupo caso (p = 0,026). Ausência de hepatotoxicidade foi fator de proteção para óbito (OR = 0,42; IC: 0,20-0,91). Coinfecção pelos vírus das hepatites B e C e linfócitos T CD4+ abaixo de 200 células/mm³ foram fatores de risco independentes para a hepatotoxicidade nesses pacientes.Reports in Public HealthCadernos de Saúde Pública2012-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/4991Reports in Public Health; Vol. 28 No. 4 (2012): 4Cadernos de Saúde Pública; v. 28 n. 4 (2012): 41678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZenghttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/4991/10203https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/4991/10204Lima, Maria de Fátima Silva deMelo, Heloísa Ramos Lacerda deinfo:eu-repo/semantics/openAccess2024-03-06T15:28:27Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/4991Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:05:44.983843Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true |
dc.title.none.fl_str_mv |
Hepatotoxicity induced by antituberculosis drugs among patients coinfected with HIV and tuberculosis |
title |
Hepatotoxicity induced by antituberculosis drugs among patients coinfected with HIV and tuberculosis |
spellingShingle |
Hepatotoxicity induced by antituberculosis drugs among patients coinfected with HIV and tuberculosis Lima, Maria de Fátima Silva de Drug Toxicity Coinfection Tuberculosis HIV |
title_short |
Hepatotoxicity induced by antituberculosis drugs among patients coinfected with HIV and tuberculosis |
title_full |
Hepatotoxicity induced by antituberculosis drugs among patients coinfected with HIV and tuberculosis |
title_fullStr |
Hepatotoxicity induced by antituberculosis drugs among patients coinfected with HIV and tuberculosis |
title_full_unstemmed |
Hepatotoxicity induced by antituberculosis drugs among patients coinfected with HIV and tuberculosis |
title_sort |
Hepatotoxicity induced by antituberculosis drugs among patients coinfected with HIV and tuberculosis |
author |
Lima, Maria de Fátima Silva de |
author_facet |
Lima, Maria de Fátima Silva de Melo, Heloísa Ramos Lacerda de |
author_role |
author |
author2 |
Melo, Heloísa Ramos Lacerda de |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Lima, Maria de Fátima Silva de Melo, Heloísa Ramos Lacerda de |
dc.subject.por.fl_str_mv |
Drug Toxicity Coinfection Tuberculosis HIV |
topic |
Drug Toxicity Coinfection Tuberculosis HIV |
description |
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 < 200cells/mm³ 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 200cells/mm³ were independent risk factors for hepatotoxicity in these patients |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-04-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/4991 |
url |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/4991 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/4991/10203 https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/4991/10204 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html application/pdf |
dc.publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
publisher.none.fl_str_mv |
Reports in Public Health Cadernos de Saúde Pública |
dc.source.none.fl_str_mv |
Reports in Public Health; Vol. 28 No. 4 (2012): 4 Cadernos de Saúde Pública; v. 28 n. 4 (2012): 4 1678-4464 0102-311X reponame:Cadernos de Saúde Pública instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ |
instname_str |
Fundação Oswaldo Cruz (FIOCRUZ) |
instacron_str |
FIOCRUZ |
institution |
FIOCRUZ |
reponame_str |
Cadernos de Saúde Pública |
collection |
Cadernos de Saúde Pública |
repository.name.fl_str_mv |
Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ) |
repository.mail.fl_str_mv |
cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br |
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1798943372219514880 |