Outcomes and safety of concomitant nevirapine and rifampicin treatment under programme conditions in Malawi.

Hdl Handle:
http://hdl.handle.net/10144/95554
Title:
Outcomes and safety of concomitant nevirapine and rifampicin treatment under programme conditions in Malawi.
Authors:
Moses, M; Zachariah, R; Tayler-Smith, K; Misinde, D; Foncha, C; Manzi, M; Bauerfeind, A; Mwagomba, B; Kwanjana, J; Harries, A D
Journal:
The International Journal of Tuberculosis and Lung Disease : the official journal of the International Union against Tuberculosis and Lung Disease
Abstract:
SETTING: Thyolo District Hospital, rural Malawi. OBJECTIVES: To report on 1) clinical, immunological and virological outcomes and 2) safety among human immunodeficiency virus (HIV) infected patients with tuberculosis (TB) who received concurrent nevirapine (NVP) and rifampicin (RMP) based treatment. DESIGN: Retrospective cohort study. METHODS: Analysis of programme data, June-December 2007. RESULTS: Of a total of 156 HIV-infected TB patients who started NVP-based antiretroviral treatment, 136 (87%) completed TB treatment successfully, 16 (10%) died and 5 (4%) were transferred out. Mean body weight and CD4 gain (adults) were respectively 4.4 kg (95%CI 3.3-5.4) and 140 cells/mm(3) (95%CI 117-162). Seventy-four per cent of patients who completed TB treatment and had a viral load performed (n = 74) had undetectable levels (<50 copies/ml), while 17 (22%) had a viral load of 50-1000 copies/ml. Hepatotoxicity was present in 2 (1.3%) patients at baseline. Two patients developed Grade 2 and one developed Grade 3 alanine transaminase enzyme elevations during TB treatment (incidence rate per 10 years of follow-up 4.2, 95%CI 1.4-13.1). There were no reported deaths linked to hepatotoxicity. CONCLUSIONS: In a rural district in Malawi, concomitant NVP and RMP treatment is associated with good TB treatment outcomes and appears safe. Further follow-up of patients would be useful to ascertain the longer-term effects of this concurrent treatment.
Affiliation:
Médecins sans Frontières, Thyolo District, Thyolo, Malawi.
Issue Date:
Feb-2010
URI:
http://hdl.handle.net/10144/95554
PubMed ID:
20074411
Language:
en
ISSN:
1815-7920
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorMoses, Men
dc.contributor.authorZachariah, Ren
dc.contributor.authorTayler-Smith, Ken
dc.contributor.authorMisinde, Den
dc.contributor.authorFoncha, Cen
dc.contributor.authorManzi, Men
dc.contributor.authorBauerfeind, Aen
dc.contributor.authorMwagomba, Ben
dc.contributor.authorKwanjana, Jen
dc.contributor.authorHarries, A Den
dc.date.accessioned2010-04-05T19:31:46Z-
dc.date.available2010-04-05T19:31:46Z-
dc.date.issued2010-02-
dc.identifier.citationOutcomes and safety of concomitant nevirapine and rifampicin treatment under programme conditions in Malawi. 2010, 14 (2):197-202 Int. J. Tuberc. Lung Dis.en
dc.identifier.issn1815-7920-
dc.identifier.pmid20074411-
dc.identifier.urihttp://hdl.handle.net/10144/95554-
dc.description.abstractSETTING: Thyolo District Hospital, rural Malawi. OBJECTIVES: To report on 1) clinical, immunological and virological outcomes and 2) safety among human immunodeficiency virus (HIV) infected patients with tuberculosis (TB) who received concurrent nevirapine (NVP) and rifampicin (RMP) based treatment. DESIGN: Retrospective cohort study. METHODS: Analysis of programme data, June-December 2007. RESULTS: Of a total of 156 HIV-infected TB patients who started NVP-based antiretroviral treatment, 136 (87%) completed TB treatment successfully, 16 (10%) died and 5 (4%) were transferred out. Mean body weight and CD4 gain (adults) were respectively 4.4 kg (95%CI 3.3-5.4) and 140 cells/mm(3) (95%CI 117-162). Seventy-four per cent of patients who completed TB treatment and had a viral load performed (n = 74) had undetectable levels (<50 copies/ml), while 17 (22%) had a viral load of 50-1000 copies/ml. Hepatotoxicity was present in 2 (1.3%) patients at baseline. Two patients developed Grade 2 and one developed Grade 3 alanine transaminase enzyme elevations during TB treatment (incidence rate per 10 years of follow-up 4.2, 95%CI 1.4-13.1). There were no reported deaths linked to hepatotoxicity. CONCLUSIONS: In a rural district in Malawi, concomitant NVP and RMP treatment is associated with good TB treatment outcomes and appears safe. Further follow-up of patients would be useful to ascertain the longer-term effects of this concurrent treatment.en
dc.language.isoenen
dc.rightsArchived with thanks to The International Journal of Tuberculosis and Lung Disease : the official journal of the International Union against Tuberculosis and Lung Diseaseen
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAnti-HIV Agentsen
dc.subject.meshAntibiotics, Antitubercularen
dc.subject.meshCohort Studiesen
dc.subject.meshDrug-Induced Liver Injuryen
dc.subject.meshFemaleen
dc.subject.meshFollow-Up Studiesen
dc.subject.meshHIV Infectionsen
dc.subject.meshHumansen
dc.subject.meshMalawien
dc.subject.meshMaleen
dc.subject.meshNevirapineen
dc.subject.meshRetrospective Studiesen
dc.subject.meshRifampinen
dc.subject.meshTreatment Outcomeen
dc.subject.meshTuberculosisen
dc.subject.meshViral Loaden
dc.subject.meshYoung Adulten
dc.titleOutcomes and safety of concomitant nevirapine and rifampicin treatment under programme conditions in Malawi.en
dc.contributor.departmentMédecins sans Frontières, Thyolo District, Thyolo, Malawi.en
dc.identifier.journalThe International Journal of Tuberculosis and Lung Disease : the official journal of the International Union against Tuberculosis and Lung Diseaseen

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