Breen and coworkers¹ showed that, in the era of effective antiretroviral therapy, discontinuation of anti-tuberculosis (TB) treatment occurred with a similar frequency in HIV-infected and HIV-uninfected individuals despite a greater rate of serious (grade III/IV) adverse events among HIV-infected individuals.

According to the Division of AIDS table for grading the severity of adult and pediatric adverse events (http://rcc.tech-res-intl.com), grade III adverse events are likely to cause inability to perform usual social and functional activities while grade IV adverse events are potentially life-threatening. However, among HIV-infected patients with grade III/IV adverse events in the above study,¹ treatment was interrupted only in a minority of patients, except for those with hepatotoxicity, and no mention was made regarding any modification of treatment regimens. With the retrospective study design, it might be difficult to exclude some degree of …