Lazarus, G.Tjoa, K.Iskandar, A.W.B.Louisa, M.Sagwa, E.L.Padayatchi, N.Soetikno, V.2024-04-212024-04-212021Lazarus G, Tjoa K, Iskandar AWB, Louisa M, Sagwa EL, Padayatchi N, Soetikno V. The effect of human immunodeficiency virus infection on adverse events during treatment of drug-resistant tuberculosis: A systematic review and meta-analysis. PLoS One. 2021 Mar 4;16(3):e0248017. doi: 10.1371/journal.pone.0248017.10.1371/journal.pone.0248017https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7932087/https://hdl.handle.net/11288/595890Background Adverse events (AEs) during drug-resistant tuberculosis (DR-TB) treatment, especially with human immunodeficiency virus (HIV) co-infection, remains a major threat to poor DR-TB treatment adherence and outcomes. This meta-analysis aims to investigate the effect of HIV infection on the development of AEs during DR-TB treatment. Methods Eligible studies evaluating the association between HIV seropositivity and risks of AE occurrence in DR-TB patients were included in this systematic review. Interventional and observational studies were assessed for risk of bias using the Risk of Bias in Nonrandomized Studies of Intervention and Newcastle-Ottawa Scale tool, respectively. Random-effects meta-analysis was performed to estimate the pooled risk ratio (RR) along with their 95% confidence intervals (CIs). Results A total of 37 studies involving 8657 patients were included in this systematic review. We discovered that HIV infection independently increased the risk of developing AEs in DR-TB patients by 12% (RR 1.12 [95% CI: 1.02–1.22]; I2 = 0%, p = 0.75). In particular, the risks were more accentuated in the development of hearing loss (RR 1.44 [95% CI: 1.18–1.75]; I2 = 60%), nephrotoxicity (RR 2.45 [95% CI: 1.20–4.98], I2 = 0%), and depression (RR 3.53 [95% CI: 1.38–9.03]; I2 = 0%). Although our findings indicated that the augmented risk was primarily driven by antiretroviral drug usage rather than HIV-related immunosuppression, further studies investigating their independent effects are required to confirm our findings. Conclusion HIV co-infection independently increased the risk of developing AEs during DR-TB treatment. Increased pharmacovigilance through routine assessments of audiological, renal, and mental functions are strongly encouraged to enable prompt diagnosis and treatment in patients experiencing AEs during concomitant DR-TB and HIV treatment.enAttribution 3.0 United Stateshttp://creativecommons.org/licenses/by/3.0/us/Antitubercular agentsHearing lossHIV infectionsDepressionSDG-03 Good health and well-beingArticlePLoS One