Biến cố trên thận và trên thính giác trong điều trị lao đa kháng ghi nhận qua hoạt động giám sát tích cực tại Việt Nam

Abstract

Ototoxity and nephrotoxicity as the main causes of adverse events of injectable anti-tuberculosis drugs were investigated by a prospective study based on a Cohort Event Monitoring (CEM) program in 9 sentinel sites in Vietnam from April 2014 to December 2016. The study involved a cohort of 659 of MDR-TB patients. Of these, 7.4% experienced at least one renal adverse event each, and 15.2% were affected by ototoxicity during treatment. Multivariate regression analysis revealed a history of existing renal/hearing problems related to nephrotoxicity/ ototoxicity respectively. Meanwhile, it was the daily dose of the injectable drugs that appeared as a risk factor to both types of the AEs. In Vietnam, nephrotoxicity and ototoxicity were quite common in MDR-TB treatment, therefore, certainly resposonsible for the MDR-TB relared renal failure and irreversible hearing loss. The findings of the related factors to nephrotoxicity and ototoxicity by this study posed weight on patient history investigation, baseline examination and close monitoring of renal function and audiometry in patients treated by MDR- TB regimens, especially those consisting of injectable drugs of the kind.