Guideline

Consensus statement: Management of drug-induced liver injury in HIV-positive patients treated for TB

E Jong, F Conradie, R Berhanu, A Black, M-A John, G Meintjes, C Menezes
Southern African Journal of HIV Medicine | Vol 14, No 3 | a63 | DOI: https://doi.org/10.4102/sajhivmed.v14i3.63 | © 2013 E Jong, F Conradie, R Berhanu, A Black, M-A John, G Meintjes, C Menezes | This work is licensed under CC Attribution 4.0
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 Africa
F 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


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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.


Keywords

drug-induced liver injury; ART; TB treatment

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