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地点:马拉维农村Thyolo区医院。目的:报告临床、免疫学和病毒学结果和艾滋病合并结核病患者同时接受奈韦拉平(NVP)和利福平(RMP)治疗的安全性。设计:回顾性队列研究。方法:分析2007年6—12月的规划数据。结果:在156例接受基于NVP抗病毒治疗的艾滋病合并结核病患者中,136例(87%)成功地完成了结核病治疗,16例(10%)死亡,5例(4%)迁出。平均体质量和CD4细胞计数增量(成人)分别为4.4 kg(95%可信区间为3.3～5.4)和140个/mm~3(95%可信区间为117～162)。在完成抗结核治疗且获得病毒载量检测结果的患者中(n=74),74%的患者病毒载量处于未检出水平(<50个拷贝/ml),17例(22%)患者的病毒载量为50～1 000个拷贝/ml。在基线时,2例(1.3%)患者出现肝中毒。在抗结核治疗期间,2例患者和1例患者分别达到2级和3级谷丙转氨酶升高(每10年的随访发病率为4.2,95%可信区间为1.4～13.1)。没有与肝中毒相关的死亡报告。结论:在马拉维的农村地区,同时服用NVP和RMP可以获得很好的结核病治疗效果,并且安全。对患者进行进一步的随访,将有助于确定目前治疗的远期效果。
Location: Thyolo District Hospital, Malawi Rural. PURPOSE: To report the safety of clinical, immunological and virologic outcomes and concurrent treatment with nevirapine (NVP) and rifampicin (RMP) in patients with AIDS-associated tuberculosis. Design: Retrospective cohort study. Methods: Analysis of the planning data from June to December 2007. RESULTS: Out of 156 patients with HIV-TB-TB-TB treated on NVP antiviral therapy, 136 (87%) successfully completed TB treatment, 16 (10%) died and 5 (4%) were extubated. Mean body mass and CD4 cell count (adult) were 4.4 kg (95% confidence interval 3.3 to 5.4) and 140 / mm 3 (95% confidence interval 117 to 162), respectively. Among patients who completed anti-TB treatment and had a viral load test (n = 74), 74% of patients had undetected viral load (<50 copies / ml) and 17 (22%) patients The viral load is 50-1000 copies / ml. At baseline, liver poisoning occurred in 2 patients (1.3%). During the anti-TB treatment, two patients and one patient achieved grade 2 and grade 3 alanine aminotransferases, respectively (with a 10-year follow-up of 4.2 and a 95% confidence interval of 1.4 to 13.1). There is no death report related to liver poisoning. Conclusion: In rural areas of Malawi, taking both NVP and RMP at the same time can provide good TB treatment and is safe. Further follow-up of patients will help determine the long-term efficacy of the current treatment.