在为结核病治疗的HIV-1血清阳性患者中,皮肤过敏反应是由于thiacetazone引起的
Lancet (London, England)
|March 16, 1991
概括
人类免疫缺陷病毒 (HIV) 显著增加了结核病治疗中使用杆菌素,异化和基 (STH) 严重皮肤反应的风险. 像SHRZ/TH这样的替代疗法可以减少艾滋病毒阳性个体的这些不良事件.
科学领域:
- 传染性疾病 传染性疾病
- 临床药理学 临床药理学
- 公共卫生 公共卫生
背景情况:
- 结核病 (TB) 管理因人类免疫缺陷病毒 (HIV) 同感染而复杂化.
- 抗结核病药物的安全性和有效性在艾滋病毒阳性个体中需要仔细评估.
- 皮肤过敏反应是结核病治疗中的一个重要问题.
研究的目的:
- 研究艾滋病毒状况对结核病治疗期间不良反应的发生率和严重性的影响.
- 为了比较不同抗结核病药物治疗方案在HIV阳性和HIV阴性患者的安全性.
- 为了确定负责过敏反应的特定药物成分.
主要方法:
- 对227名结核病患者的回顾性分析,根据艾滋病毒状况和治疗方案 (STH与SHRZ/TH) 进行对比结果.
- 详细记录和分析皮肤过敏反应和其他不良事件.
- 在经历过反应的患者中进行药物特定挑战测试.
主要成果:
- 艾滋病病毒阳性患者在接受STH治疗时,皮肤过敏反应的发生率 (20%) 与艾滋病病毒阴性患者 (1%) 相比显著更高 (RR=18).
- 与SHRZ/TH疗法相比,STH疗法与艾滋病毒阳性患者早期反应的更高率有关 (p=0.04).
- 在大多数过敏反应中,thiacetazone被确定为可能的罪祸首药物,在7名受挑战的患者中,有6名反应.
结论:
- 艾滋病病毒阳性状态是STH结核病治疗期间严重皮肤药物不良反应的主要风险因素.
- 在HIV阳性结核病患者的过敏反应方面,SHRZ/TH疗法似乎更安全.
- 这些发现对高艾滋病毒患病率环境中的结核病控制计划具有关键意义,需要重新评估标准治疗指南.
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