@article{Veenstra2023,
abstract = {Background: Treatment-limiting severe cutaneous adverse reactions (SCAR) occur more commonly amongst persons with HIV-associated tuberculosis (TB). The impact of SCAR on long-term HIV/TB outcomes is unknown. Methods: Patients with TB and/or HIV admitted to Groote Schuur Hospital, Cape Town, South Africa with SCAR between 1/10/2018 and 30/09/2021 were eligible. Follow-up data was collected for 6- and 12-month outcomes: mortality, TB and antiretroviral therapy (ART) regimen changes, TB treatment completion, and CD4 count recovery. Results: Forty-eight SCAR admissions included: 34, 11, and 3 HIV-associated TB, HIV-only and TB-only patients with 32, 13 and 3 cases of drug reaction with eosinophilia and systemic symptoms, Stevens-Johnson syndrome/toxic epidermal necrolysis and generalised bullous fixed-drug eruption respectively. Nine (19{\%}), all HIV-positive (eight co-infected with TB), were deceased at 12-months, and 12(25{\%}) were lost to follow-up. Amongst TB-SCAR patients, seven (21{\%}) were discharged on all four first-line anti-TB drugs (FLTD), while 12(33{\%}) had regimens with no FLTDs; 24/37(65{\%}) completed TB treatment. Amongst HIV-SCAR patients, 10/31(32{\%}) changed ART regimen. If retained in care (24/36), median (IQR) CD4 counts increased at 12-months post-SCAR (115(62–175) vs. 319(134–439) cells/uL). Conclusion: SCAR admission amongst patients with HIV-associated TB results in substantial mortality, and considerable treatment complexity. However, if retained in care, TB regimens are successfully completed, and immune recovery is good despite SCAR.},
author = {Veenstra, S and Porter, M N and Thwala, B N and Pillay, N and Panieri, M A and van der Westhuizen, J and Phillips, E J and Meintjes, Graeme A and Dlamini, S and Lehloenya, R J and Peter, J},
doi = {10.1016/J.JCTUBE.2023.100374},
issn = {2405-5794},
journal = {Journal of Clinical Tuberculosis and Other Mycobacterial Diseases},
keywords = {CD4 count,DRESS,Drug allergy,Mortality,OA,SJS/TEN,Viral load,fund{\_}ack,original},
mendeley-tags = {OA,fund{\_}ack,original},
month = {aug},
pages = {100374},
publisher = {Elsevier},
title = {{Long-term HIV and tuberculosis outcomes in patients hospitalised with severe cutaneous adverse reactions}},
volume = {32},
year = {2023}
}

{"_id":"FfzqYmvCzmYd7Cke7","bibbaseid":"veenstra-porter-thwala-pillay-panieri-vanderwesthuizen-phillips-meintjes-etal-longtermhivandtuberculosisoutcomesinpatientshospitalisedwithseverecutaneousadversereactions-2023","author_short":["Veenstra, S","Porter, M N","Thwala, B N","Pillay, N","Panieri, M A","van der Westhuizen, J","Phillips, E J","Meintjes, G. A","Dlamini, S","Lehloenya, R J","Peter, J"],"bibdata":{"bibtype":"article","type":"article","abstract":"Background: Treatment-limiting severe cutaneous adverse reactions (SCAR) occur more commonly amongst persons with HIV-associated tuberculosis (TB). The impact of SCAR on long-term HIV/TB outcomes is unknown. Methods: Patients with TB and/or HIV admitted to Groote Schuur Hospital, Cape Town, South Africa with SCAR between 1/10/2018 and 30/09/2021 were eligible. Follow-up data was collected for 6- and 12-month outcomes: mortality, TB and antiretroviral therapy (ART) regimen changes, TB treatment completion, and CD4 count recovery. Results: Forty-eight SCAR admissions included: 34, 11, and 3 HIV-associated TB, HIV-only and TB-only patients with 32, 13 and 3 cases of drug reaction with eosinophilia and systemic symptoms, Stevens-Johnson syndrome/toxic epidermal necrolysis and generalised bullous fixed-drug eruption respectively. Nine (19%), all HIV-positive (eight co-infected with TB), were deceased at 12-months, and 12(25%) were lost to follow-up. Amongst TB-SCAR patients, seven (21%) were discharged on all four first-line anti-TB drugs (FLTD), while 12(33%) had regimens with no FLTDs; 24/37(65%) completed TB treatment. Amongst HIV-SCAR patients, 10/31(32%) changed ART regimen. If retained in care (24/36), median (IQR) CD4 counts increased at 12-months post-SCAR (115(62–175) vs. 319(134–439) cells/uL). Conclusion: SCAR admission amongst patients with HIV-associated TB results in substantial mortality, and considerable treatment complexity. However, if retained in care, TB regimens are successfully completed, and immune recovery is good despite SCAR.","author":[{"propositions":[],"lastnames":["Veenstra"],"firstnames":["S"],"suffixes":[]},{"propositions":[],"lastnames":["Porter"],"firstnames":["M","N"],"suffixes":[]},{"propositions":[],"lastnames":["Thwala"],"firstnames":["B","N"],"suffixes":[]},{"propositions":[],"lastnames":["Pillay"],"firstnames":["N"],"suffixes":[]},{"propositions":[],"lastnames":["Panieri"],"firstnames":["M","A"],"suffixes":[]},{"propositions":["van","der"],"lastnames":["Westhuizen"],"firstnames":["J"],"suffixes":[]},{"propositions":[],"lastnames":["Phillips"],"firstnames":["E","J"],"suffixes":[]},{"propositions":[],"lastnames":["Meintjes"],"firstnames":["Graeme","A"],"suffixes":[]},{"propositions":[],"lastnames":["Dlamini"],"firstnames":["S"],"suffixes":[]},{"propositions":[],"lastnames":["Lehloenya"],"firstnames":["R","J"],"suffixes":[]},{"propositions":[],"lastnames":["Peter"],"firstnames":["J"],"suffixes":[]}],"doi":"10.1016/J.JCTUBE.2023.100374","issn":"2405-5794","journal":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","keywords":"CD4 count,DRESS,Drug allergy,Mortality,OA,SJS/TEN,Viral load,fund_ack,original","mendeley-tags":"OA,fund_ack,original","month":"aug","pages":"100374","publisher":"Elsevier","title":"Long-term HIV and tuberculosis outcomes in patients hospitalised with severe cutaneous adverse reactions","volume":"32","year":"2023","bibtex":"@article{Veenstra2023,\r\nabstract = {Background: Treatment-limiting severe cutaneous adverse reactions (SCAR) occur more commonly amongst persons with HIV-associated tuberculosis (TB). The impact of SCAR on long-term HIV/TB outcomes is unknown. Methods: Patients with TB and/or HIV admitted to Groote Schuur Hospital, Cape Town, South Africa with SCAR between 1/10/2018 and 30/09/2021 were eligible. Follow-up data was collected for 6- and 12-month outcomes: mortality, TB and antiretroviral therapy (ART) regimen changes, TB treatment completion, and CD4 count recovery. Results: Forty-eight SCAR admissions included: 34, 11, and 3 HIV-associated TB, HIV-only and TB-only patients with 32, 13 and 3 cases of drug reaction with eosinophilia and systemic symptoms, Stevens-Johnson syndrome/toxic epidermal necrolysis and generalised bullous fixed-drug eruption respectively. Nine (19{\\%}), all HIV-positive (eight co-infected with TB), were deceased at 12-months, and 12(25{\\%}) were lost to follow-up. Amongst TB-SCAR patients, seven (21{\\%}) were discharged on all four first-line anti-TB drugs (FLTD), while 12(33{\\%}) had regimens with no FLTDs; 24/37(65{\\%}) completed TB treatment. Amongst HIV-SCAR patients, 10/31(32{\\%}) changed ART regimen. If retained in care (24/36), median (IQR) CD4 counts increased at 12-months post-SCAR (115(62–175) vs. 319(134–439) cells/uL). Conclusion: SCAR admission amongst patients with HIV-associated TB results in substantial mortality, and considerable treatment complexity. However, if retained in care, TB regimens are successfully completed, and immune recovery is good despite SCAR.},\r\nauthor = {Veenstra, S and Porter, M N and Thwala, B N and Pillay, N and Panieri, M A and van der Westhuizen, J and Phillips, E J and Meintjes, Graeme A and Dlamini, S and Lehloenya, R J and Peter, J},\r\ndoi = {10.1016/J.JCTUBE.2023.100374},\r\nissn = {2405-5794},\r\njournal = {Journal of Clinical Tuberculosis and Other Mycobacterial Diseases},\r\nkeywords = {CD4 count,DRESS,Drug allergy,Mortality,OA,SJS/TEN,Viral load,fund{\\_}ack,original},\r\nmendeley-tags = {OA,fund{\\_}ack,original},\r\nmonth = {aug},\r\npages = {100374},\r\npublisher = {Elsevier},\r\ntitle = {{Long-term HIV and tuberculosis outcomes in patients hospitalised with severe cutaneous adverse reactions}},\r\nvolume = {32},\r\nyear = {2023}\r\n}\r\n","author_short":["Veenstra, S","Porter, M N","Thwala, B N","Pillay, N","Panieri, M A","van der Westhuizen, J","Phillips, E J","Meintjes, G. A","Dlamini, S","Lehloenya, R J","Peter, J"],"key":"Veenstra2023","id":"Veenstra2023","bibbaseid":"veenstra-porter-thwala-pillay-panieri-vanderwesthuizen-phillips-meintjes-etal-longtermhivandtuberculosisoutcomesinpatientshospitalisedwithseverecutaneousadversereactions-2023","role":"author","urls":{},"keyword":["CD4 count","DRESS","Drug allergy","Mortality","OA","SJS/TEN","Viral load","fund_ack","original"],"metadata":{"authorlinks":{}}},"bibtype":"article","biburl":"https://drive.google.com/uc?export=download&id=1-JLqZ7RwZ3VC2d6ErLGHAtOeMRS_7GCz","dataSources":["Krmt6gt9ktB2s6ARh","KmoiX2LKn8hjsLMkh","XbBjMG3Fzj4C9dGTw"],"keywords":["cd4 count","dress","drug allergy","mortality","oa","sjs/ten","viral load","fund_ack","original"],"search_terms":["long","term","hiv","tuberculosis","outcomes","patients","hospitalised","severe","cutaneous","adverse","reactions","veenstra","porter","thwala","pillay","panieri","van der westhuizen","phillips","meintjes","dlamini","lehloenya","peter"],"title":"Long-term HIV and tuberculosis outcomes in patients hospitalised with severe cutaneous adverse reactions","year":2023}