Full Text Available

Access Repository
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
Cover Image

Long-term HIV and tuberculosis outcomes in co-infected patients with treatment limiting severe cutaneous adverse reactions

Background Treatment-limiting severe cutaneous adverse reactions (SCAR) occur more commonly amongst persons co-infected with tuberculosis (TB) and advanced HIV. The impact of SCAR on long-term HIV and TB outcomes is unknown. Methods Patients with active TB and/or HIV admitted to Groote Schuur Hospit...

Full description

Saved in:
Main Author: Veenstra, Simon
Other Authors: Peter, Jonathan
Format: Thesis
Language:Eng
Published: Department of Medicine 2024
Subjects:
Internal Medicine
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1867613245568712704
access_status_str Open Access
author Veenstra, Simon
author2 Peter, Jonathan
author_browse Peter, Jonathan
Veenstra, Simon
author_facet Peter, Jonathan
Veenstra, Simon
author_sort Veenstra, Simon
collection Thesis
description Background Treatment-limiting severe cutaneous adverse reactions (SCAR) occur more commonly amongst persons co-infected with tuberculosis (TB) and advanced HIV. The impact of SCAR on long-term HIV and TB outcomes is unknown. Methods Patients with active TB and/or HIV admitted to Groote Schuur Hospital, Cape Town, South Africa with SCAR between 1/10/2018 and 30/09/2021 were eligible. Clinical and laboratory follow-up data was collected for 6 and 12-month outcomes: mortality, TB and antiretroviral therapy (ART) regimen changes, TB treatment completion, and CD4 count recovery. Results Forty-eight SCAR admissions included: 34, 11, and 3 HIV-associated TB, HIV-only and TB-only patients with 32, 13 and 3 cases of drug reaction with eosinophilia and systemic symptoms, StevensJohnson syndrome/toxic epidermal necrolysis and generalised bullous fixed drug eruption respectively. Nine (19%), all HIV-positive, were deceased at 12-months, and 12 (25%) were lost to all care levels. Amongst TB-SCAR patients, seven (21%) were discharged on all four first-line anti-TB drugs (FLTD), while 12 (33%) had discharge regimens with no FLTDs; 24/37 (65%) completed TB treatment. Amongst HIV-SCAR patients, 10/31 (32%) changed ART regimen. If retained in care (24/36), median (IQR) CD4 counts increased by 12-months post-SCAR (115 (62-175) vs. 319 (134-439) cells/uL). Conclusion SCAR admission amongst patients with HIV-associated TB results in substantial mortality, and considerable treatment complexity. However, if retained in care, TB regimens are successfully completed, and immune recovery is good despite SCAR.
format Thesis
id oai:open.uct.ac.za:11427/40194
institution University of Cape Town (South Africa)
language Eng
last_indexed 2026-06-10T12:33:05.164Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2024
publishDateRange 2024
publishDateSort 2024
publisher Department of Medicine
publisherStr Department of Medicine
record_format dspace
source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/40194 Long-term HIV and tuberculosis outcomes in co-infected patients with treatment limiting severe cutaneous adverse reactions Veenstra, Simon Peter, Jonathan Internal Medicine Background Treatment-limiting severe cutaneous adverse reactions (SCAR) occur more commonly amongst persons co-infected with tuberculosis (TB) and advanced HIV. The impact of SCAR on long-term HIV and TB outcomes is unknown. Methods Patients with active TB and/or HIV admitted to Groote Schuur Hospital, Cape Town, South Africa with SCAR between 1/10/2018 and 30/09/2021 were eligible. Clinical and laboratory follow-up data was collected for 6 and 12-month outcomes: mortality, TB and antiretroviral therapy (ART) regimen changes, TB treatment completion, and CD4 count recovery. Results Forty-eight SCAR admissions included: 34, 11, and 3 HIV-associated TB, HIV-only and TB-only patients with 32, 13 and 3 cases of drug reaction with eosinophilia and systemic symptoms, StevensJohnson syndrome/toxic epidermal necrolysis and generalised bullous fixed drug eruption respectively. Nine (19%), all HIV-positive, were deceased at 12-months, and 12 (25%) were lost to all care levels. Amongst TB-SCAR patients, seven (21%) were discharged on all four first-line anti-TB drugs (FLTD), while 12 (33%) had discharge regimens with no FLTDs; 24/37 (65%) completed TB treatment. Amongst HIV-SCAR patients, 10/31 (32%) changed ART regimen. If retained in care (24/36), median (IQR) CD4 counts increased by 12-months post-SCAR (115 (62-175) vs. 319 (134-439) cells/uL). Conclusion SCAR admission amongst patients with HIV-associated TB results in substantial mortality, and considerable treatment complexity. However, if retained in care, TB regimens are successfully completed, and immune recovery is good despite SCAR. 2024-07-02T10:12:17Z 2024-07-02T10:12:17Z 2023 2024-06-06T13:53:08Z Thesis / Dissertation Masters MMed http://hdl.handle.net/11427/40194 Eng application/pdf Department of Medicine Faculty of Health Sciences
spellingShingle Internal Medicine
Veenstra, Simon
Long-term HIV and tuberculosis outcomes in co-infected patients with treatment limiting severe cutaneous adverse reactions
thesis_degree_str Master's
title Long-term HIV and tuberculosis outcomes in co-infected patients with treatment limiting severe cutaneous adverse reactions
title_full Long-term HIV and tuberculosis outcomes in co-infected patients with treatment limiting severe cutaneous adverse reactions
title_fullStr Long-term HIV and tuberculosis outcomes in co-infected patients with treatment limiting severe cutaneous adverse reactions
title_full_unstemmed Long-term HIV and tuberculosis outcomes in co-infected patients with treatment limiting severe cutaneous adverse reactions
title_short Long-term HIV and tuberculosis outcomes in co-infected patients with treatment limiting severe cutaneous adverse reactions
title_sort long term hiv and tuberculosis outcomes in co infected patients with treatment limiting severe cutaneous adverse reactions
topic Internal Medicine
url http://hdl.handle.net/11427/40194
work_keys_str_mv AT veenstrasimon longtermhivandtuberculosisoutcomesincoinfectedpatientswithtreatmentlimitingseverecutaneousadversereactions

Similar Items