Fatores de risco para hepatotoxicidade do tratamento para tuberculose em pacientes internados e coinfectados pelo HIV

AUTOR(ES)

Maria de FÃtima Silva de Lima

DATA DE PUBLICAÇÃO

2009

RESUMO

Introduction: The treatment of tuberculosis is complicated by difficulties such as low adherence, drugs interaction and toxicity. The risk of hepatotoxicity associated to anti-tuberculosis drugs is three to five times greater among patients infected by HIV, when compared to those not infected. Objective: To determine risk factors for hepatotoxicity among patients infected with HIV and submitted to treatment for tuberculosis. Patients and Methods: According to a retrospective, case control study, 156 patients interned at two university hospitals at Recife, Pernambuco, Brazil, from January 2004 and October 2007, were divided into two groups: 57 (36.5Â%) cases and 99 (63.5%) controls, according to the presence of hepatotoxicity, diagnosed by clinical and laboratorial criteria. Biological, behavioral and laboratory factors were investigated related to HIV/aids infection and to anti-retroviral and tuberculosis treatment, as well as to hospital denouement. Results: One has detected that cases more frequently presented opportunist infections, history of previous hepatic diseases, co-infection with B or C hepatitis virus, major HIV viral loud, and minor T CD4+ lymphocytes count. There was a significant difference on denouncement; discharge was more frequent among controls (82%) and deaths, among cases (33.9%) (p=0.026). Within multivariate analysis, coinfection with B or C hepatitis virus (p=0.029) and T CD4+ lymphocytes count (p<0.001) were associated to hepatotoxicity. Conclusion: Among patients coinfected with HIV submitted to tuberculosis treatment, minor T CD4+ lymphocytes count and co-infection with B or C hepatitis virus must be interpreted as risk factors to hepatotoxicity

ASSUNTO(S)

hiv - tuberculosis infections toxicidade de drogas estudo de casos e controles toxicity to drugs infecÃÃes por hiv - tuberculose risk factors medicina fatores de risco casecontrol study

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