关键词: HIV感染, 获得性免疫缺陷综合征, 结核, 药物性肝损伤, 危险因素, 因素分析,统计学

Abstract:

Objective To investigate the clinical characteristics and risk factors of drug-induced liver injury in with hospitalized tuberculosis (TB) patients complicated with HIV/AIDS. Methods Clinical data of 164 TB patients complicated with HIV/AIDS co-infection from the Public Health Clinical Center of Chengdu in 2017 were retrospecively analyzed. The data included gender, age, type of TB, HIV-infected route, whether or not complicated with viral hepatitis B (HBV) and/or viral hepatitis C (HCV), count of CD4⁺T cell, history of highly active anti-retroviral therapy (HAART), sulfonamides and antifungal treatment, etc. The patients were divided into liver injury group (n=87) and non-liver injury group (n=77) according to the occurrence of drug-induced liver injury within 2 weeks after anti-TB drug treatment, and the risk factors of drug-induced liver injury was analyzed. Results Multivariate logistic regression analysis showed that CD4⁺T cell count between 200-<414 cells/μl and the use of antifungal drugs were independent risk factors for drug-induced liver injury in TB patients complicated with HIV/AIDS during anti-TB drug treatment (Wald χ²=6.769, P=0.009, OR (95%CI)=13.357 (1.895-94.136); Wald χ²=7.122, P=0.008, OR (95%CI)=2.834 (1.319-6.089)). Conclusion When treated with anti-TB drug, TB patients complicated with HIV/AIDS should be alert to the drug-induced liver injury if CD4⁺T cell counts between 200 and 414 cells/μl and anti-fungal treatment. Frequent monitoring, early detection and early intervention should be conducted, and so as the preventive liver protection treatment if necessary .

Key words: HIV infections, Acquired immunodeficiency syndrome, Tuberculosis, Drug-induced liver injury DILI, Risk factors, Factor analysis, statistical