title: Adverse events in an integrated home-based treatment program for MDR-TB and HIV in KwaZulu-Natal, South Africa.
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 home-based care setting.
authors.affiliation: *Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY †Philanjalo and Church of Scotland Hospital, Tugela Ferry, South Africa ‡Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa §Department of Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY ‖Health Systems Research Unit, Medical Research Council, Cape Town, South Africa ¶Department of Medicine, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa; Departments of #Medicine and **Epidemiology, Yale University School of Medicine, New Haven, CT ††Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA.
authors.forename: James C M
authors.initials: JC
authors.lastname: Brust
authors.forename: N Sarita
authors.initials: NS
authors.lastname: Shah
authors.forename: Theo L
authors.initials: TL
authors.lastname: van der Merwe
authors.forename: Sheila
authors.initials: S
authors.lastname: Bamber
authors.forename: Yuming
authors.initials: Y
authors.lastname: Ning
authors.forename: Moonseong
authors.initials: M
authors.lastname: Heo
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Moll
authors.forename: Marian
authors.initials: M
authors.lastname: Loveday
authors.forename: Umesh G
authors.initials: UG
authors.lastname: Lalloo
authors.forename: Gerald H
authors.initials: GH
authors.lastname: Friedland
authors.forename: Neel R
authors.initials: NR
authors.lastname: Gandhi
mesh_terms: D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006699:Home Care Services; D006801:Humans; D013019:South Africa; D018088:Tuberculosis, Multidrug-Resistant / Q000150:complications / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents