Monitoramento das reações adversas ao novo tratamento da tuberculose

Abstract

Tuberculosis is an infectious disease that despite the effective prophylactic and therapeutic resources is one of the most serious problems of global public health. In 2014, there were 67,966 new cases of the disease in Brazil, with the highest incidence rate in the states of Amazonas, Rio de Janeiro, Acre, Pernambuco, Mato Grosso and Pará. Three factors contribute to continuity of tuberculosis in Brazil: the HIV pandemic the development of multiresistant strains and failure of BCG. The lack of adherence to treatment is one of the main reasons the spread of resistance. In order to reduce this problem and minimize adverse reactions, WHO in 2006 recommended a new regimen: 2RHZE (intensive phase) and 4R (maintenance phase), which was adopted by Brazil in 2010. However, adverse reactions requiring discontinuation of treatment has not been estimated with the new regimen, which justifies this study aimed to analyze the occurrence of adverse events in subjects with tuberculosis in the use of new treatment regimen (Isoniazid, Rifampin, Ethambutol, Pyrazinamide). A prospective longitudinal study of 57 subjects with clinical diagnosis, laboratory and radiological tuberculosis. The renal function tests (urea and creatinine) and liver (AST, ALT, alkaline phosphatase, bilirubin and gamma GT) were performed every month of treatment. In the study, Disease affected more males with low education, who used tobacco and alcohol and regardless of age. There were increasing urea values in the last two months of treatment, but creatinine was normal during treatment. Regarding the assessment of liver function, fluctuations were observed in biochemical parameters analyzed, but remained in the normal range. It is noteworthy that a subject has developed framework of cholestatic liver disease, which resolved upon discontinuation of treatment. Early diagnosis, coupled with immediate treatment enables the patient an effective outcome in the fight against tuberculosis, as it keeps the biochemical parameters without major changes, allowing for a better adherence and clinical improvement of the patient.