title: Severe cutaneous hypersensitivity reactions during treatment of tuberculosis in patients with HIV infection in Tanzania.
abstract: Concurrent infection with HIV-1 and Mycobacterium tuberculosis is increasingly common in East Africa. In the past, a drug regimen consisting of 2 months of intramuscular streptomycin plus 12 months of isoniazid and thiacetazone has been used in tuberculosis control programs with acceptable efficacy and low incidence of adverse reactions. Anecdotal reports of increasing cases of Stevens-Johnson syndrome prompted a 2 month prospective search for cases of severe cutaneous hypersensitivity reactions at Muhimbili Medical Centre in Dar es Salaam, Tanzania. Five such patients were admitted to a single ward during this time, 4 of whom were HIV-seropositive and all of whom were being treated with isoniazid and thiacetazone. These findings have implications for the management of tuberculosis in East Africa and perhaps other countries with high prevalence of both HIV-1 and tuberculosis.
authors.affiliation: Department of Medicine, Duke University, Medical Center, Durham, North Carolina.
authors.forename: C S
authors.initials: CS
authors.lastname: Dukes
authors.forename: J
authors.initials: J
authors.lastname: Sugarman
authors.forename: J P
authors.initials: JP
authors.lastname: Cegielski
authors.forename: G J
authors.initials: GJ
authors.lastname: Lallinger
authors.forename: D H
authors.initials: DH
authors.lastname: Mwakyusa
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000453:epidemiology; D000328:Adult; D015897:Comorbidity; D004338:Drug Combinations; D003875:Drug Eruptions / Q000453:epidemiology / Q000209:etiology*; D004359:Drug Therapy, Combination; D005260:Female; D015497:HIV-1; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007538:Isoniazid / Q000009:adverse effects*; D008297:Male; D011159:Population Surveillance; D011446:Prospective Studies; D013262:Stevens-Johnson Syndrome / Q000139:chemically induced* / Q000453:epidemiology; D013307:Streptomycin / Q000009:adverse effects; D013636:Tanzania / Q000453:epidemiology; D013828:Thioacetazone / Q000009:adverse effects*; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D004338:Drug Combinations; D013828:Thioacetazone; D007538:Isoniazid; D013307:Streptomycin