The Dept of Anaesthesia & Intensive Care, CUHK
First posted December 2006 by Charles Gomersall
Should include at least:
Other regimes are recommended for patients with serum aminotransferase concentrations >3 times upper limit of normal before the start of therapy and for management of drug resistance or treatment failure.
In addition to the usual complications of anti-TB therapy, patients with HIV disease are at risk of developing an immune reconstitution reaction, particularly those who are concurrently receiving anti-retroviral therapy.
Substantial adverse drug interactions occur between rifamycins (eg rifampicin, rifabutin) and commonly used anti-retrovirals as a result of induction of the the hepatic cytochrome P450 system. Rifampicin is the most potent inducer with rifabutin resulting in significantly less induction.
Click here for IDSA recommended dose adjustments when anti-retroviral therapy and rifabutin are adminstered simultaneously.
The optimal time for initiating anti-retroviral therapy in patients with TB is controversial. Although early therapy may decrease HIV disease progression it may be associated with a relatively high incidence of adverse effects and immune reconstitution reactions. Most clinicians choose to wait 4-8 weeks. Patients already receiving anti-retroviral therapy at the time of diagnosis of TB require careful review of their therapy.
Treating Opportunistic Infections among HIV-Infected Adults and Adolescents: Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association/Infectious Diseases Society of America
© Charles Gomersall, December 2006
April, 2014 unless
otherwise stated. The author, editor and The Chinese University of Hong Kong
take no responsibility for any adverse event resulting from the use of this