Female sex and discontinuation of isoniazid due to adverse effects during the treatment of latent tuberculosis
Female sex and discontinuation of isoniazid due to adverse effects during the treatment of latent tuberculosis
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DOI：
10.1016/j.jinf.2013.07.015
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发表时间：
2013-11-01
影响因子：
28.2
通讯作者：
Sterling, Timothy R.
中科院分区：
文献类型：
--
作者：
Pettit, April C.;Bethel, James;Sterling, Timothy R.
目的：为了确定率和危险因素的异烟肼停药，由于在治疗过程中的潜在tuberculosis infection in a large，multi-site study.Methods的不良反应：结核病流行病学研究联盟（TBESC）进行了一项前瞻性研究，从2007年3月至2008年9月在成人开始异烟肼治疗LTBI在12个网站在美国和加拿大。使用负二项回归确定因不良反应而停用异烟肼的相对风险。结果：在1306例异烟肼初始治疗者中，617例（47.2%，95%CI44.5 -50.0%）完成治疗，196例（15.0%，95%CI13.1 -17.1%）因不良反应而停药。在多变量分析中，女性（RR 1.67，95% CI 1.32-2.10，p < 0.001）和当前饮酒情况（RR 1.41，95%CI 1.13-1.77，p = 0.003）与因不良反应而停用异烟肼独立相关。由于不良反应而停用异烟肼的比率比以前报告的高得多。由于不良反应，妇女停用异烟肼的风险增加;可能需要密切监测妇女的不良反应。目前饮酒也与异烟肼停药有关;建议患者戒酒可以减少因不良反应而停药。(c)2013年，英国传染病协会。由爱思唯尔有限公司出版。保留所有权利。
Objectives: To determine the rate of and risk factors for discontinuation of isoniazid due to adverse effects during the treatment of latent tuberculosis infection in a large, multi-site study.Methods: The Tuberculosis Epidemiologic Studies Consortium (TBESC) conducted a prospective study from March 2007-September 2008 among adults initiating isoniazid for treatment of LTBI at 12 sites in the US and Canada. The relative risk for isoniazid discontinuation due to adverse effects was determined using negative binomial regression. Adjusted models were constructed using forward stepwise regression.Results: Of 1306 persons initiating isoniazid, 617 (47.2%, 95% CI 44.5-50.0%) completed treatment and 196 (15.0%, 95% CI 13.1-17.1%) discontinued due to adverse effects. In multivariable analysis, female sex (RR 1.67, 95% CI 1.32-2.10, p < 0.001) and current alcohol use (RR 1.41, 95% CI 1.13-1.77, p = 0.003) were independently associated with isoniazid discontinuation due to adverse effects.Conclusions: The rate of discontinuation of isoniazid due to adverse effects was substantially higher than reported earlier. Women were at increased risk of discontinuing isoniazid due to adverse effects; close monitoring of women for adverse effects may be warranted. Current alcohol use was also associated with isoniazid discontinuation; counseling patients to abstain from alcohol could decrease discontinuation due to adverse effects. (c) 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.