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Hepatocellular injury in children treated for rifampicin-resistant tuberculosis: incidence, aetiology and outcome
Thesis (MMed) -- Stellenbosch University, 2022.
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| Format: | Thesis |
| Language: | en_ZA |
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Stellenbosch : Stellenbosch University
2022
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| _version_ | 1867614037978644480 |
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| access_status_str | Open Access |
| author | Duvenhage, Joanie |
| author2 | Schaaf, Hendrik Simon |
| author_browse | Duvenhage, Joanie Schaaf, Hendrik Simon |
| author_facet | Schaaf, Hendrik Simon Duvenhage, Joanie |
| author_sort | Duvenhage, Joanie |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MMed) -- Stellenbosch University, 2022. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/126156 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:45:40.774Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/126156 Hepatocellular injury in children treated for rifampicin-resistant tuberculosis: incidence, aetiology and outcome Duvenhage, Joanie Schaaf, Hendrik Simon Hesseling, Anneke Catharina Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health. Drugs -- Side effects Tuberculosis in children Drug resistance Hepatocellular Liver metastasis UCTD Thesis (MMed) -- Stellenbosch University, 2022. ENGLISH ABSTRACT: Background: Hepatocellular injury has been commonly reported in adults on treatment for rifampicin-resistant tuberculosis (RR-TB). However, there are limited data in children. Methods: Two observational pharmacokinetic studies of children (0-17 years) routinely treated for RR-TB were conducted in Cape Town, South Africa between October 2011 and February 2020. All hepatocellular injury adverse events (AEs; defined as elevated alanine aminotransferase [ALT]) were documented. Data were analyzed to determine the incidence, aetiology, risk factors, management and outcome of ALT elevation. Results: A total of 217 children, median age 3.6 years at enrolment (IQR: 1.7, 7.1) were included. The median follow-up time was 14.0 months (IQR: 9.8, 17.2). Fifty-five (25.3%) developed an ALT AE. Of these, 43/55 (78%) children had 54 ALT AEs attributed to their RR-TB treatment. The incidence rate of ALT AEs related to RR-TB treatment was 22.4 per 100 person-years. Positive HIV status and having an elevated ALT at enrolment were associated with time to ALT AE attributed to RR-TB treatment, with p-values of 0.0427 and p<0.0001, respectively. Hepatitis A IgM was positive in 11/14 (78.6%) of grade ≥3 cases of ALT AEs. In 8/14 (57%) of severe ALT AEs, hepatotoxic drugs were stopped or temporarily interrupted. No children had a fatal or unresolved outcome. Conclusions: Hepatocellular injury in children on RR-TB treatment is common, although usually mild; having elevated ALT early in treatment and HIV-positive status are possible risk factors for the development of hepatocellular injury on treatment. Hepatitis A was a common cause of severe ALT AE in children treated for RR-TB. AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar. Masters 2022-11-17T11:02:00Z 2023-01-16T12:52:57Z 2022-11-17T11:02:00Z 2023-01-16T12:52:57Z 2021-08 Thesis http://hdl.handle.net/10019.1/126156 en_ZA Stellenbosch University 117 pages application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Drugs -- Side effects Tuberculosis in children Drug resistance Hepatocellular Liver metastasis UCTD Duvenhage, Joanie Hepatocellular injury in children treated for rifampicin-resistant tuberculosis: incidence, aetiology and outcome |
| title | Hepatocellular injury in children treated for rifampicin-resistant tuberculosis: incidence, aetiology and outcome |
| title_full | Hepatocellular injury in children treated for rifampicin-resistant tuberculosis: incidence, aetiology and outcome |
| title_fullStr | Hepatocellular injury in children treated for rifampicin-resistant tuberculosis: incidence, aetiology and outcome |
| title_full_unstemmed | Hepatocellular injury in children treated for rifampicin-resistant tuberculosis: incidence, aetiology and outcome |
| title_short | Hepatocellular injury in children treated for rifampicin-resistant tuberculosis: incidence, aetiology and outcome |
| title_sort | hepatocellular injury in children treated for rifampicin resistant tuberculosis incidence aetiology and outcome |
| topic | Drugs -- Side effects Tuberculosis in children Drug resistance Hepatocellular Liver metastasis UCTD |
| url | http://hdl.handle.net/10019.1/126156 |
| work_keys_str_mv | AT duvenhagejoanie hepatocellularinjuryinchildrentreatedforrifampicinresistanttuberculosisincidenceaetiologyandoutcome |