การศึกษาลักษณะทางคลินิกและผลลัพธ์ของการรักษาวัณโรคระยะแฝงในผู้อยู่ร่วมเอชไอวีในโรงพยาบาลมะการักษ์

Benjawan Sengliu

Authors

Benjawan Sengliu Department of Medicine, Makarak Hospital, Kanchanaburi

Keywords:

Tuberculosis preventive treatment, Latent tuberculosis infection, Adverse drug reactions, People living with HIV

Abstract

Background: Tuberculosis remains the leading cause of mortality among people living with HIV (PLHIV). Tuberculosis preventive treatment (TPT) is a key strategy to reduce progression from latent tuberculosis infection (LTBI) to active disease. However, real-world data on TPT outcomes in Thailand remain limited.

Objective: To evaluate clinical characteristics, treatment outcomes, adverse drug effects, and factors associated with incomplete TPT among PLHIV at Makarak Hospital, Kanchanaburi, Thailand.

Methods: A retrospective chart review was conducted among PLHIV aged ≥15 years who received TPT between January 1, 2021, and December 31, 2025.

Results: A total of 76 patients were included, with a nearly equal distribution of males and females. The mean age was 36.4 ± 12.6 years, and the mean CD4 count was 309.4 ± 290.2 cells/mm³. Most patients (95%) had received antiretroviral therapy for less than one year. The predominant antiretroviral regimen was tenofovir/lamivudine/dolutegravir (88%), and the most common TPT regimen was 1HP (88%). The treatment completion rate was 96%, while 4% of patients did not complete treatment. Causes of incomplete treatment included treatment interruption, death, and drug-related rash. Adverse events included pruritic rash (8%), nausea and vomiting (4%), myalgia (3%), and peripheral neuropathy (3%). Factors significantly associated with incomplete treatment were the 9H regimen (p = 0.003), pruritic rash (p = 0.008), and peripheral neuropathy (p = 0.020). Patients with incomplete treatment had a lower mean CD4 count than those with complete treatment (61.7 vs. 319.6 cells/mm³), although the difference was not statistically significant.

Conclusion: Treatment of latent tuberculosis infection among people living with HIV demonstrated a high treatment success rate, particularly with short-course regimens. Adverse events were uncommon; however, pruritic rash was associated with incomplete treatment outcomes. Other causes of treatment failure included loss to follow-up and death among patients receiving long-course regimens. In addition, patients with incomplete treatment outcomes had lower CD4 cell counts than those with complete treatment outcomes, although this difference was not statistically significant.

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