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Journal of Tropical Medicine
Volume 2014, Article ID 904957, 9 pages
http://dx.doi.org/10.1155/2014/904957
Clinical Study

Effectiveness and Safety of Concurrent Use of First-Line Antiretroviral and Antituberculous Drugs in Rwanda

1Unit of Clinical Pharmacology, Faculty of Medicine, National University of Rwanda, Huye, Rwanda
2Infectious Diseases Unit, Department of Internal Medicine, Kigali University Teaching Hospital, Kigali, Rwanda
3Rwanda Biomedical Centre, Kigali, Rwanda

Received 20 September 2013; Revised 8 November 2013; Accepted 2 December 2013; Published 30 January 2014

Academic Editor: Sasithon Pukrittayakamee

Copyright © 2014 Justin Ntokamunda Kadima et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Overlapping toxicity between drugs used for HIV and TB could complicate the management of HIV/TB coinfected patients, particularly those carrying multiple opportunistic infections. This study aimed to evaluate the clinical outcomes and adverse drug events in HIV patients managed with first-line antiretroviral and first-line anti-TB drugs. Methods. This is a retrospective study utilizing medical dossiers from single-HIV infected and HIV/TB coinfected patients already initiated on ART. Predictors of outcomes included changes in CD4 cells/mm3, body weight, physical improvement, death rate, and adverse drug reactions. Results. Records from 60 HIV patients and 60 HIV/TB patients aged between 20 and 58 years showed that all clinical indicators of effectiveness were better in single-HIV infected than in HIV/TB coinfected patients: higher CD4 cell counts, better physical improvement, and low prevalence of adverse drug events. The most frequently prescribed regimen was TDF/3TC/EFV+RHZE. The mortality rate was 20% in HIV/TB patients compared to 8.3% in the single-HIV group. Conclusion. Treatment regimens applied are efficient in controlling the progression of the infection. However, attention should be paid to adjust dosing when combining nonnucleoside antiretrovirals (EFV and NVR) with anti-TB drugs to minimize the risk of death by drug intoxication.