Guideline
Consensus statement: Management of drug-induced liver injury in HIV-positive patients treated for TB
Submitted: 12 December 2013 | Published: 17 September 2013
About the author(s)
E Jong, Clinical HIV Research Unit, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaF Conradie, Clinical HIV Research Unit, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
R Berhanu, TB Focal Point, Right to Care, Johannesburg, South Africa
A Black, Wits Reproductive Health and HIV Institute, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
M-A John, Durban International Clinical Trials Unit, University of KwaZulu-Natal, Durban, South Africa
G Meintjes, Institute of Infectious Disease and Molecular Medicine, and Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
C Menezes, Division of Infectious Diseases, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Abstract
Drug-induced liver injury (DILI) in HIV/tuberculosis (TB) co-infected patients is a common problem in the South African setting, and re-introduction of anti-TB drugs can be challenging for the healthcare worker. Although international guidelines on the re-introduction of TB treatment are available, the definition of DILI is not uniform, management of antiretroviral therapy (ART) in HIV co-infection is not mentioned, and the guidance on management is not uniform and lacks a practical approach. In this consensus statement, we summarise important aspects of DILI and provide practical guidance for healthcare workers for different patient groups and healthcare settings on the re-introduction of anti-TB drugs and ART in HIV/TB co-infected individuals presenting with DILI.
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