ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
High Rates of Drug-induced Liver Injury in People Living With HIV Coinfected With Tuberculosis (TB) Irrespective of Antiretroviral Therapy Timing During Antituberculosis Treatment: Results From the Starting Antiretroviral Therapy at Three Points in TB Trial.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 27 citations in OpenAlex.
- Adverse drug reactions, particularly liver disorders, drive interruptions in anti-tuberculosis treatment: A retrospective cohort study.British journal of clinical pharmacology · 2025Article
- Patient Determinants and Effects on Adherence of Adverse Drug Reactions to Tuberculosis Treatment: A Prospective Cohort Analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Clinical Features of Anti-Tuberculosis Drug-Induced Liver Injury and Risk Factors for Severe Cases: A Retrospective Study in China.Infection and drug resistance · 2025Article
- Predictors of severe hepatotoxicity among retroviral infected adults on HAART regimen in Ilubabor Zone, Southwest Ethiopia.Scientific reports · 2024Article
- Prediction Models for Adverse Drug Reactions During Tuberculosis Treatment in Brazil.The Journal of infectious diseases · 2024Article
- Clinical standards for the management of adverse effects during treatment for TB.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2023Article
- Unsuccessful treatment outcome and associated risk factors. A prospective study of DR-TB patients from a high burden country, Pakistan.PloS one · 2023Observational
- Diagnosis and treatment of tuberculosis in adults with HIV.Medicine · 2022Review
- The Correlated Risk Factors for Severe Liver Damage Among HIV-Positive Inpatients With Abnormal Liver Tests.Frontiers in medicine · 2022Article
- Liver function in COVID-19 infection.World journal of hepatology · 2021Review
- Liver Impairment and Hematological Changes in Patients with Chronic Hepatitis C and COVID-19: A Retrospective Study after One Year of Pandemic.Medicina (Kaunas, Lithuania) · 2021Article
- Liver injury, SARS-COV-2 infection and COVID-19: What physicians should really know?GastroHep · 2021Review
- COVID-19 and drug-induced liver injury: a problem of plenty or a petty point?Archives of toxicology · 2020Article
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Authors and funding
7 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundNew onset or worsening drug-induced liver injury challenges coinfected patients on antiretroviral therapy (ART) initiation during antituberculosis (TB) treatment.
methodsPost hoc analysis within a randomized trial, the Starting Antiretroviral Therapy at Three Points in Tuberculosis trial, was conducted. Patients were randomized to initiate ART either early or late during TB treatment or after TB treatment completion. Liver enzymes were measured at baseline, 6-month intervals, and when clinically indicated.
resultsAmong 642 patients enrolled, the median age was 34 years (standard deviation, 28-40), and 17.6% had baseline CD4+ cell counts <50 cells/mm3. Overall, 146/472 patients (52, 47, and 47: early, late, and sequential arms) developed new-onset liver injury following TB treatment initiation. The incidence of liver injury post-ART initiation in patients with CD4+ cell counts <200 cells/mm3 and ≥200 cells/ mm3 was 27.4 (95% confidence interval [CI], 18.0-39.8), 19.0 (95% CI, 10.9-30.9), and 18.4 (95% CI, 8.8-33.8) per 100 person-years, and 32.1 (95% CI, 20.1-48.5), 11.8 (95% CI, 4.3-25.7), and 28.2 (95% CI, 13.5-51.9) per 100 person-years in the early, late integrated, and sequential treatment arms, respectively. Severe and life-threatening liver injury occurred in 2, 7, and 3 early, late, and sequential treatment arm patients, respectively. Older age and hepatitis B positivity predicted liver injury.
conclusionsHigh incidence rates of liver injury among cotreated human immunodeficiency virus (HIV)-TB coinfected patients were observed. Clinical guidelines and policies must provide guidance on frequency of liver function monitoring for HIV-TB coinfected patients.
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