Safety implications of combined antiretroviral and anti-tuberculosis drugs.

Safety implications of combined antiretroviral and anti-tuberculosis drugs. Expert Opin Drug Saf. 2019 Dec 06;:1-19 Authors: Cerrone M, Bracchi M, Wasserman S, Pozniak A, Meintjes G, Cohen K, Wilkinson RJ Abstract Introduction: Antiretroviral and anti-tuberculosis (TB) drugs are often co-administered in people living with HIV (PLWH). Early initiation of antiretroviral therapy (ART) during TB treatment improves survival in patients with advanced HIV disease. However, safety concerns related to clinically significant changes in drug exposure resulting from drug-drug interactions, development of overlapping toxicities and specific challenges related to co-administration during pregnancy represent barriers to successful combined treatment for HIV and TB.Areas covered: Pharmacokinetic interactions of different classes of ART when combined with anti-TB drugs used for sensitive-, drug-resistant (DR) and latent TB are discussed. Overlapping drug toxicities, implications of immune reconstitution inflammatory syndrome (IRIS), safety in pregnancy and research gaps are also explored.Expert opinion: New antiretroviral and anti-tuberculosis drugs have been recently introduced and international guidelines updated. A number of effective molecules and clinical data are now available to build treatment regimens for PLWH with latent or active TB. Adopting a systematic approach that also takes into account the need for individualized variations based on the available evidenc...
Source: Expert Opinion on Drug Safety - Category: Drugs & Pharmacology Tags: Expert Opin Drug Saf Source Type: research

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d J Abstract Swedish National tuberculosis (TB) guidelines recommend screening of active and latent TB (LTBI) among pregnant women (PW) from high endemic countries or previous exposure to possibly improve early detection and treatment.We evaluated cascade of care of a newly introduced TB screening program of PW in Stockholm county 2016-2017. The algorithm included clinical data and Quantiferon® (QFT) at the Maternal Health Care clinics and referral for specialist care upon positive test or TB symptoms.About 29 000 HIV negative PW were registered yearly, where of 11% originated from high-endemic countries. In...
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: Eur Respir J Source Type: research
CONCLUSIONS: A number of new tools and strategies to make TPT a standard of care in HIV programmes have become available. The new TPT regimens are safe and effective and can be used with current ART, with attention being paid to potential drug-drug interactions between rifamycins and some classes of antiretrovirals. More research and development is needed to optimize TPT for small children, pregnant women and drug-resistant TB (DR-TB). Effective programmatic scale-up can be supported through context-adapted demand creation strategies and the inclusion of TPT in client-centred services, such as differentiated service delive...
Source: Journal of the International AIDS Society - Category: Infectious Diseases Tags: J Int AIDS Soc Source Type: research
Publication date: January 2020Source: Pathology - Research and Practice, Volume 216, Issue 1Author(s): Hui Wang, Rani KanthanAbstractAmoebiasis, caused by the intestinal protozoan Entamoeba histolytica, though a relatively common parasitic disease in the tropical and subtropical regions, is uncommon in the developed countries. In these countries, as amoebic colitis shares similar clinical symptoms and endoscopic features with inflammatory bowel disease (IBD), these cases can be easily unrecognized and misdiagnosed.In this case report, we discuss the case of an adult patient with invasive intestinal amoebiasis, who was init...
Source: Pathology Research and Practice - Category: Pathology Source Type: research
Abstract Tuberculosis is an important cause of maternal morbidity, but little is known about the effects of pregnancy on anti-tuberculosis drug concentrations. We developed population pharmacokinetic models to describe drug disposition of isoniazid, pyrazinamide, and ethambutol in pregnant women with tuberculosis and HIV.HIV-positive pregnant women with tuberculosis receiving standard first-line tuberculosis treatment and participating in Tshepiso, a prospective cohort study in Soweto, South Africa, underwent sparse pharmacokinetic sampling at>36 weeks gestation and 7 weeks postpartum. The effects of pregnancy ...
Source: Antimicrobial Agents and Chemotherapy - Category: Microbiology Authors: Tags: Antimicrob Agents Chemother Source Type: research
Authors: Erenel H, Alpay V, Alakbarova U, Mut A, Atilgan H, Demiroz AS, Ocal P PMID: 31826685 [PubMed - as supplied by publisher]
Source: Journal of Obstetrics and Gynaecology - Category: OBGYN Tags: J Obstet Gynaecol Source Type: research
CONCLUSIONS: Evidence to date does not support the use of shortened ATT regimens in adults with newly diagnosed drug-sensitive pulmonary tuberculosis. Four-month ATT regimens that replace ethambutol with moxifloxacin or gatifloxacin, or isoniazid with moxifloxacin, increase relapse substantially compared to standard six-month ATT regimens, although treatment success and serious adverse events are little or no different. The results of six large ongoing trials will help inform decisions on whether shortened ATT regimens can replace standard six-month ATT regimens. 9 December 2019 Up to date All studies incorporated from mos...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
By SAURABH JHA, MD Slumdog TB No one knows who gave Rahul Roy tuberculosis. Roy’s charmed life as a successful trader involved traveling in his Mercedes C class between his apartment on the plush Nepean Sea Road in South Mumbai and offices in Bombay Stock Exchange. He cared little for Mumbai’s weather. He seldom rolled down his car windows – his ambient atmosphere, optimized for his comfort, rarely changed. Historically TB, or “consumption” as it was known, was a Bohemian malady; the chronic suffering produced a rhapsody which produced fine art. TB was fashionable in Victorian Britain...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Artificial Intelligence Health Tech Saurabh Jha TB tuberculosis Source Type: blogs
ConclusionsTo our knowledge, this study documents the first example of a successful PPP with government partnership in a high-income country to address undocumented migrants ’ lack of access to health services in general and HIV care in particular. In light of the intensification of North-South migration, this Israeli case study could be useful for other countries facing similar challenges. It also has lessons within Israel, as the country grapples with other health p roblems among uninsured communities.
Source: Israel Journal of Health Policy Research - Category: International Medicine & Public Health Source Type: research
In conclusion, the rResult of this study indicates that ATD's had varied degree of toxicity, all the ATDs have considerable adverse effect on the functional competence of male and female gametes, however, with varied degree of toxicity functional potential.Graphical abstract
Source: Environmental Toxicology and Pharmacology - Category: Environmental Health Source Type: research
Source: American Journal of Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Images in Obstetrics Source Type: research
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