Open AccessPrevalence Of Hepatotoxicity In HIV-Positive, Tuberculosis And HIV+TB Co Infected Patients In Tertiary Care Hospitals , Sindh
Author(s) -
Arsalan Ahmed Uqaili,
Marvi Gurbakhshani,
Zahid Ali Shaikh,
Imdad Ali Ansari,
Keenjhar Gurbakhshani
Publication year - 2020
Publication title -
international journal of medical science and clinical invention
Language(s) - English
Resource type - Journals
eISSN - 2454-9576
pISSN - 2348-991X
DOI - 10.18535/ijmsci/v7i08.02
Subject(s) - medicine , tuberculosis , efavirenz , incidence (geometry) , rifampicin , population , pyrazinamide , lamivudine , discontinuation , ethambutol , gastroenterology , human immunodeficiency virus (hiv) , immunology , viral load , hepatitis b virus , virus , physics , environmental health , pathology , antiretroviral therapy , optics
Hepatotoxicity is historically the 3rd most common reason for drug withdrawal and toxicity-related discontinuation of treatment. This study was aimed at determining the incidence and the onset of hepatotoxicity and at evaluating the relationship of some risk factors for hepatotoxicity among Human Immunodeciency Virus- (HIV-) positive, tuberculosis (TB), and HIV/TB patients on treatment. This was a prospective follow-up study involving 125 participants from the HIV/AIDS and TB treatment centres in Tertiary Care hospital of Larkana and Sukkur, Sindh. These TB and HIV patients were initiated on RHEZ (R = Rifampicin, H = Isoniazid, E = Ethambutol, and P = Pyrazinamide) and TELE (efavirenz/tenofovir/lamivudine), respectively, and followed up for 12 weeks between September 2018 and November 2019. The levels of liver enzymes (transaminases, gamma- glutamyltransferase, alkaline phosphatase, and unconjugated/total bilirubin) were measured spectrophotometrically using serum. The Chi-squared (χ2) test was used to assess the association between risk factors and hepatotoxicity, while the Kaplan-Meier survival analysis with the log-rank test was used to determine the occurrence of hepatotoxicity in the dierent groups. We followed the general study population for a total person time of 6580 person-days, with an incidence rate and cumulative incidence of 8 cases per 1000 person-days (53/6580 person-days) and 42.4% (53/125), respectively (95% condence interval), recorded after 12 weeks of follow-up of all the participants. The onset of hepatotoxicity in the total study population was statistically signicant (χ2 = 9:5334; p = 0:022979; CI = 95%), with the majority observed at week eight of follow-up. Also, the incidence rate and cumulative incidence of hepatotoxicity with respect to HIV/AIDS, TB, and HIV/TB patients, respectively, at 95% condence interval were: 8 cases per 1000 person-days (32/3843 person-days) and 32/76 (42.1%), 6 cases per 1000 person- days (12/1932 person-days) and 12/32 (37.5%), and 11 cases per 1000 person-days (9/805 person-days) and 9/17 (52.9%). This study shows that the incidence rate and cumulative incidence of hepatotoxicity in HIV/AIDS, TB, and HIV/TB patients on treatment were high . Also, it is very important to check these patients’ liver function especially within the rst 12 weeks of treatment.