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Impact of adverse drug reactions on the outcomes of tuberculosis treatment

BACKGROUND: Adverse drug reactions (ADR) challenge successful anti-tuberculosis treatment (ATT). The aim of this study was to evaluate the impact of ATT-associated ADR and related factors on ATT outcomes. METHODS: A prospective cohort study of persons with tuberculosis (TB) at a referral center in R...

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Autores principales: Sant´Anna, Flávia M., Araújo-Pereira, Mariana, Schmaltz, Carolina A. S., Arriaga, María B., Andrade, Bruno B., Rolla, Valeria C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9904486/
https://www.ncbi.nlm.nih.gov/pubmed/36749743
http://dx.doi.org/10.1371/journal.pone.0269765
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author Sant´Anna, Flávia M.
Araújo-Pereira, Mariana
Schmaltz, Carolina A. S.
Arriaga, María B.
Andrade, Bruno B.
Rolla, Valeria C.
author_facet Sant´Anna, Flávia M.
Araújo-Pereira, Mariana
Schmaltz, Carolina A. S.
Arriaga, María B.
Andrade, Bruno B.
Rolla, Valeria C.
author_sort Sant´Anna, Flávia M.
collection PubMed
description BACKGROUND: Adverse drug reactions (ADR) challenge successful anti-tuberculosis treatment (ATT). The aim of this study was to evaluate the impact of ATT-associated ADR and related factors on ATT outcomes. METHODS: A prospective cohort study of persons with tuberculosis (TB) at a referral center in Rio de Janeiro, Brazil, from 2010 to 2016. Baseline information: race, sex, schooling, economic status, tobacco, drugs and alcohol abuse, HIV-infection status and comorbidities were captured during TB screening and diagnosis. Laboratory exams were performed to confirm TB diagnosis and monitor ADRs, favorable (cure and treatment completion) and unfavorable (death, loss to follow up and failure) outcomes were prospectively captured. The Kaplan-Meier curve was used to estimate the probability of ADR-free time. A logistic regression analysis (backward elimination) was performed to identify independent associations with unfavorable outcomes. RESULTS: 550 patients were enrolled, 35.1% were people living with HIV (PLHIV) and ADR occurred in 78.6% of all participants. Smoking (OR: 2.32; 95% CI:1.34–3.99) and illicit-drug use (OR:2.02; 95% CI:1.15–3.55) were independent risk factors for unfavorable outcomes. In PLHIV, alcohol abuse and previous ART use were associated with unfavorable outcomes. In contrast, ADR increased the odds of favorable outcomes in the overall population. PLHIV more frequently experienced grade 3/4-ADR (18.36%), especially “liver and biliary system disorders”. Lower CD4 counts (<100 cells/uL) were associated with hepatotoxicity (p = 0.03). ART-naïve participants presented a higher incidence of ADR in comparison with ART-experienced patients. CONCLUSION: Substance use was associated with unfavorable outcomes, highlighting the need for better strategies to reduce this habit. In contrast, ADRs were associated with favorable outcomes. Attention to the occurrence of ADR in PLHIV is essential, especially regarding hepatotoxicity in those with high immunosuppression.
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spelling pubmed-99044862023-02-08 Impact of adverse drug reactions on the outcomes of tuberculosis treatment Sant´Anna, Flávia M. Araújo-Pereira, Mariana Schmaltz, Carolina A. S. Arriaga, María B. Andrade, Bruno B. Rolla, Valeria C. PLoS One Research Article BACKGROUND: Adverse drug reactions (ADR) challenge successful anti-tuberculosis treatment (ATT). The aim of this study was to evaluate the impact of ATT-associated ADR and related factors on ATT outcomes. METHODS: A prospective cohort study of persons with tuberculosis (TB) at a referral center in Rio de Janeiro, Brazil, from 2010 to 2016. Baseline information: race, sex, schooling, economic status, tobacco, drugs and alcohol abuse, HIV-infection status and comorbidities were captured during TB screening and diagnosis. Laboratory exams were performed to confirm TB diagnosis and monitor ADRs, favorable (cure and treatment completion) and unfavorable (death, loss to follow up and failure) outcomes were prospectively captured. The Kaplan-Meier curve was used to estimate the probability of ADR-free time. A logistic regression analysis (backward elimination) was performed to identify independent associations with unfavorable outcomes. RESULTS: 550 patients were enrolled, 35.1% were people living with HIV (PLHIV) and ADR occurred in 78.6% of all participants. Smoking (OR: 2.32; 95% CI:1.34–3.99) and illicit-drug use (OR:2.02; 95% CI:1.15–3.55) were independent risk factors for unfavorable outcomes. In PLHIV, alcohol abuse and previous ART use were associated with unfavorable outcomes. In contrast, ADR increased the odds of favorable outcomes in the overall population. PLHIV more frequently experienced grade 3/4-ADR (18.36%), especially “liver and biliary system disorders”. Lower CD4 counts (<100 cells/uL) were associated with hepatotoxicity (p = 0.03). ART-naïve participants presented a higher incidence of ADR in comparison with ART-experienced patients. CONCLUSION: Substance use was associated with unfavorable outcomes, highlighting the need for better strategies to reduce this habit. In contrast, ADRs were associated with favorable outcomes. Attention to the occurrence of ADR in PLHIV is essential, especially regarding hepatotoxicity in those with high immunosuppression. Public Library of Science 2023-02-07 /pmc/articles/PMC9904486/ /pubmed/36749743 http://dx.doi.org/10.1371/journal.pone.0269765 Text en © 2023 Sant´Anna et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Sant´Anna, Flávia M.
Araújo-Pereira, Mariana
Schmaltz, Carolina A. S.
Arriaga, María B.
Andrade, Bruno B.
Rolla, Valeria C.
Impact of adverse drug reactions on the outcomes of tuberculosis treatment
title Impact of adverse drug reactions on the outcomes of tuberculosis treatment
title_full Impact of adverse drug reactions on the outcomes of tuberculosis treatment
title_fullStr Impact of adverse drug reactions on the outcomes of tuberculosis treatment
title_full_unstemmed Impact of adverse drug reactions on the outcomes of tuberculosis treatment
title_short Impact of adverse drug reactions on the outcomes of tuberculosis treatment
title_sort impact of adverse drug reactions on the outcomes of tuberculosis treatment
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9904486/
https://www.ncbi.nlm.nih.gov/pubmed/36749743
http://dx.doi.org/10.1371/journal.pone.0269765
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