International Journal of STD & AIDS > Volume 20, Number 5 > Pp. 339-345

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Original research articles

Adverse events to antituberculosis therapy: influence of HIV and antiretroviral drugs

D J B Marks MBBS PhD ^* , K Dheda FCP(SA) PhD  , R Dawson FCP(SA) , G Ainslie FRCP  and R F Miller FRCP 

^* Centre for Molecular Medicine, University College London, London, UK; Division of Pulmonology, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa; Centre for Infectious Diseases and International Health; Research Department of Infection and Population Health, University College London, London, UK

Correspondence to: Dr D J B Marks Email: d.marks{at}ucl.ac.uk

This study investigated whether serious adverse events (SAEs) during antituberculosis therapy occur more frequently in HIV co-infected patients in a South African population. A retrospective analysis examined incidences of hepatotoxicity, peripheral neuropathy, severe arthralgia, persistent vomiting and severe rash in 400 patients treated for tuberculosis in a community clinic. A total of 141 patients were co-infected with HIV, among whom only 16.3% were receiving antiretrovirals. Details of SAEs were ascertainable in 331/400 patients, and occurred in 26.7% of HIV-infected and 13.3% of HIV-uninfected individuals (P = 0.003). The excess was attributable to increased peripheral neuropathy (8.3% and 1.9%, respectively, P = 0.009) and persistent vomiting (13.3% and 3.3%, P = 0.001). SAE occurrence was not related to antiretroviral use, although median CD4 counts were lower in those experiencing side-effects (130 and 259 cells/µL, P = 0.008). The treatment completion did not differ significantly between the two groups (76.6% and 84.2%, P = 0.08).

Key Words: tuberculosis • HIV • adverse events • neuropathy • South Africa

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