1. Adverse events in an integrated, home-based treatment program for MDR-TB & HIV in Tugela Ferry, South Africa JCM Brust*, NS Shah, TL van der Merwe, S Bamber, A Mngadi, Y Ning, M Heo, AP Moll, M Loveday, UG Lalloo, GH Friedland, and NR Gandhi Background: –MDR TB treatment has many side effects –>80% of patients with MDR TB in KwaZulu-Natal, South Africa are HIV+ –Safety/tolerability of concurrent ART is unknown. –Treatment increasingly being given in ambulatory care models. Methods: –91 patients with confirmed MDR TB, treated in a home-based program in rural KwaZulu-Natal. –Visited daily by injection team. –If HIV+, ART initiated as soon as possible. –Screened monthly for adverse events (AEs) by clinician at decentralized clinic. –Labs drawn monthly. TSH six-monthly –All AEs reviewed retrospectively

2. Results Adverse events common, but generally mild. No significant differences between HIV+ on ART and HIV-negative Rarely had to change MDR TB or HIV treatment Hypothyroidism common and often required replacement therapy. Nearly all lab adverse events resolved spontaneously on repeat testing. † n=73 with available TSH

3. N=91 Conclusion: –Concurrent treatment for MDR TB and HIV is safe and generally tolerable. –With supportive care, can complete treatment with good outcomes. –Home-based treatment is a reasonable model, even for co-infected patients in rural area.