The spectrum of adverse events in the treatment of multidrug-resistant tuberculosis among people receiving antiretroviral therapy


DOI: https://dx.doi.org/10.18565/epidem.2021.11.2.100-5

Degtyareva S.Yu., Zimina V.N., Pokrovskaya А.V., Konovalova A.A., Volchenkov G.V.

1) Peoples’ Friendship University of Russia, Moscow, Russia; 2) National Medical Research Center for Phthisiopulmonology and Infectious Diseases, Moscow, Russia; 3) Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; 4) H-Clinic University Clinic, Moscow, Russia; 5) Center for Specialized Phthisiopulmonological Care, Vladimir, Russia
The outcomes of treatment for multidrug-resistant tuberculosis (MDR-TB) are significantly inferior to those in the absence of M. tuberculosis resistance. The presence of HIV infection further worsens the prognosis in these patients, including due to an increase in the frequency of adverse events (AEs) of therapy.
Objective. To analyze the structure of AEs in the simultaneous treatment of MDR-TB and HIV infection and to study their possible relationship to antiretroviral drugs.
Subjects and methods. Design: a retrospective cohort study. The investigators studied the medical records of patients over the age of 18 who had been registered for the Fourth TB chemotherapy regimen in Vladimir and the Vladimir Region in 2014-2016 and received antiretroviral therapy (ART) at the first stage of treatment.
Results. AEs of varying severity were observed in 63.3% of patients. The most often recorded cases were gastrointestinal AES (18.1%); the little less often cases were hepatotoxic and myelotoxic AEs (11.1% each). Among the patients receiving antiretroviral therapy based on protease inhibitors; AEs were significantly more common than those in the group of individuals taking non-nucleoside reverse transcriptase inhibitors.
Conclusion. AES during combination therapy for MDR-TB and HIV infection were found with high frequency. Further investigations are advisable to improve the algorithms for their monitoring and prevention.
Keywords: tuberculosis, antiretroviral therapy, combination therapy, side effects, HIV infection, safety
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About the Autors

Svetlana Yu. Degtyareva, Assistant Lecturer, Department of Infectious Diseases with Courses in Epidemiology and Phthisiology, Medical Institute, Peoples’ Friendship University of Russia, Moscow, Russia; degtyareva_svet@mail.ru; https://orcid.org/0000-0001-8836-4447
Vera N. Zimina, МD, Professor, Department of Infectious Diseases with Courses in Epidemiology and Phthisiology, Medical Institute. Peoples’ Friendship University of Russia; Leading Researcher, National Medical Research Center of Phthisiopulmonology and Infectious Diseases, Moscow, Russia; vera-zim@yandex.ru; https://orcid.org/0000-0003-3726-9022
Anastasia V. Pokrovskaya, Cand. Med. Sci., Senior Researcher, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; Associate Professor, Department of Infectious Diseases with Courses in Epidemiology and Phthisiology, Medical Institute, Peoples’ Friendship University of Russia; Moscow, Russia; pokrovskaya_av@mail.ru; https://orcid.org/0000-0002-2677-0404
Anastasia A. Konovalova, Infectiologist, H-Clinic University Clinic, Moscow, Russia; konovalova@h-clinic.ru
Grigory V. Volchenkov, Head Doctor, Center for Specialized Phthisiopulmonological Care, Vladimir, Russia


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