994. Adverse Events in HIV/TB coinfected patients in a Rural State - 2004-2009
Session: Poster Abstract Session: Clinical Studies of Tuberculosis
Saturday, October 22, 2011
Room: Poster Hall B1
Background: HIV is considered the highest risk factor for reactivation TB disease.  TB drugs and HIV drugs cause a myriad of adverse reactions.  We reviewed HIV/TB co-infected cases in Mississippi for adverse events, related and unrelated to medications, as well as completion of an CDC approved TB treatment

Methods: We reviewed the Mississippi State Department of Health TB data base for HIV/TB co-infected patients from 2004-2009. Demographic and clinical data including race, gender, age, CD4 count, and medications were reviewed.  Information regarding length of therapy, physical complaints, death before or during treatment and discontinuation of medications was reviewed for adverse events before and during treatment.  Adverse events due to drugs was defined as any side effect that caused a change in TB therapy

Results: There were 71 HIV/TB co-infected TB cases from 2004-2009.  CD4 counts ranged from 1 to 2900 (mean 212 +/- 421; mode 82) 72% were male, 87% African American, 6% were foreign born with a median age of 45 years.  Almost ¾’s were taking HAART medication.  TB disease was culture positive in 58(82%) and three had drug resistant disease. Forty-three (60.5%) reported any adverse event including death (n=13), elevated liver tests (n=9 excludes hyperbilirubinemia) and rash (n=3).  Excluding those who died 57% had an adverse event while on TB treatment.  No deaths were related to TB medication adverse events.  Among the 43 with adverse events, 29 (76%) were on HAART. TB meds were held or changed in 25 (42%) non death events. TB treatment was started in 64 (82%) of co-infected cases. Five died within 2 months of treatment.  Of the 59 remaining all completed the provider recommended treatment. Forty-seven completed a standard 6 month CDC regimen. 

Conclusion: In this cohort 60.5% HIV/TB patients experienced some adverse event including death, increased liver tests and rash.  Adverse events due to TB drugs occurred in 25 (58%) requiring that TB meds be held or altered.  Although medication changes were made, 82% of those alive at end of treatment completed a CDC approved TB treatment regimen and all completed the provider prescribed regimen


Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

Miriam Abadie1, Brian Temple, MD2,3, Imran Sunesara, MBBS, MPH4, Thomas Dobbs, M.D., M.P.H.5, Harold Henderson, MD6, Michael Holcombe, None7 and Risa Webb, MD, DTMH4,7,8, (1)University of Mississippi School of Medicine, Jackson, MS, (2)Infectious Diseases, University of Mississippi Medical Center, Jackson, MS, (3)Infectious Diseases, The Warren Alpert Medical School of Brown University, Providence, RI, (4)University of Mississippi Medical Center, Jackson, MS, (5)Mississippi State Department of Health, Hattisburg, MS, (6)University of Mississippi, Jackson, MS, (7)MS State Dept of Health, Jackson, MS, (8)G.V. "Sonny" Montgomery VA Medical Center, Jackson, MS

Disclosures:

M. Abadie, None

B. Temple, None

I. Sunesara, None

T. Dobbs, None

H. Henderson, None

M. Holcombe, None

R. Webb, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.