The effect of human immunodeficiency virus infection on adverse events during treatment of drug-resistant tuberculosis: A systematic review and meta-analysis

Adverse events (AEs) during drug-resistant tuberculosis (DR-TB) treatment, especially with human immunodeficiency virus (HIV) co-infection, remains a major threat to poor DR-TB treatment adherence and outcomes. This meta-analysis aims to investigate the effect of HIV infection on the development of...

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Veröffentlicht in:PloS one Jg. 16; H. 3; S. e0248017
Hauptverfasser: Lazarus, Gilbert, Tjoa, Kevin, Iskandar, Anthony William Brian, Louisa, Melva, Sagwa, Evans L., Padayatchi, Nesri, Soetikno, Vivian
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Public Library of Science 04.03.2021
Public Library of Science (PLoS)
Schlagworte:
Bacilli
Bias
Biology and Life Sciences
Care and treatment
Clinical outcomes
Complications and side effects
Cross-sectional studies
Drafting software
Drug resistance
Drug resistance in microorganisms
Drugs
Editing
Genetic aspects
Global health
Health risks
HIV
HIV infection
Human immunodeficiency virus
Infections
Isoniazid
Medicine
Medicine and Health Sciences
Meta-analysis
Multidrug resistance
Pathogenesis
Patients
Pharmacology
Physical Sciences
Physiological aspects
Public health
Quality assessment
Quality control
Research and Analysis Methods
Rifampin
Risk factors
Systematic review
Tuberculosis
Viruses
Indonesia
Jakarta Indonesia
ISSN:1932-6203, 1932-6203
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Zusammenfassung:Adverse events (AEs) during drug-resistant tuberculosis (DR-TB) treatment, especially with human immunodeficiency virus (HIV) co-infection, remains a major threat to poor DR-TB treatment adherence and outcomes. This meta-analysis aims to investigate the effect of HIV infection on the development of AEs during DR-TB treatment. Eligible studies evaluating the association between HIV seropositivity and risks of AE occurrence in DR-TB patients were included in this systematic review. Interventional and observational studies were assessed for risk of bias using the Risk of Bias in Nonrandomized Studies of Intervention and Newcastle-Ottawa Scale tool, respectively. Random-effects meta-analysis was performed to estimate the pooled risk ratio (RR) along with their 95% confidence intervals (CIs). A total of 37 studies involving 8657 patients were included in this systematic review. We discovered that HIV infection independently increased the risk of developing AEs in DR-TB patients by 12% (RR 1.12 [95% CI: 1.02-1.22]; I2 = 0%, p = 0.75). In particular, the risks were more accentuated in the development of hearing loss (RR 1.44 [95% CI: 1.18-1.75]; I2 = 60%), nephrotoxicity (RR 2.45 [95% CI: 1.20-4.98], I2 = 0%), and depression (RR 3.53 [95% CI: 1.38-9.03]; I2 = 0%). Although our findings indicated that the augmented risk was primarily driven by antiretroviral drug usage rather than HIV-related immunosuppression, further studies investigating their independent effects are required to confirm our findings. HIV co-infection independently increased the risk of developing AEs during DR-TB treatment. Increased pharmacovigilance through routine assessments of audiological, renal, and mental functions are strongly encouraged to enable prompt diagnosis and treatment in patients experiencing AEs during concomitant DR-TB and HIV treatment.
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Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0248017