Tuberculosis medical therapy special conditions: Difference between revisions
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#''Patients with TB, who are known to be HIV-positive, and all TB patients who live in areas where HIV is prevalent, should be treated with at least the intensive phase of the TB treatment.'' | #''Patients with TB, who are known to be HIV-positive, and all TB patients who live in areas where HIV is prevalent, should be treated with at least the intensive phase of the TB treatment.'' | ||
#''During the continuation phase of the treatment, these patients should also receive a daily dose.'' | #''During the continuation phase of the treatment, these patients should also receive a daily dose.'' | ||
#''In the impossibility of taking the daily dose, a continuation phase of 3 times/week is acceptable.'' | #''In the impossibility of taking the daily dose, a continuation phase of 3 times/week is acceptable.'' Regarding the duration of therapy, some experts recommend prolongation of TB treatment in certain HIV-positive patients.<ref name=MMWR>{{cite web | title = Treatment of tuberculosis | url = http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5211a1.htm }}</ref> | ||
===Patients Taking ART=== | ===Patients Taking ART=== | ||
Revision as of 19:49, 17 September 2014
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
HIV Coinfection
Depending on the treatment status of each patient, different approaches may be taken:[1]
Patients Not Taking ART
- After the diagnosis of TB in HIV-positive patients, not taking antiretroviral therapy (ART), the priority is to initiate treatment for TB, along with co-trimoxazole and ART.
- These patients should be treated with the same regimen as HIV-negative patients, with the exception that the optional 3 times/week of intensive phase treatment, is mandatory for HIV-positive patients. This leads to a decrease in incidence of TB relapse and resistance to rifampicin, often seen in HIV-positive patients.[2][3]
According to the WHO, the following recommendations should be applied to these patients:[3]
- Patients with TB, who are known to be HIV-positive, and all TB patients who live in areas where HIV is prevalent, should be treated with at least the intensive phase of the TB treatment.
- During the continuation phase of the treatment, these patients should also receive a daily dose.
- In the impossibility of taking the daily dose, a continuation phase of 3 times/week is acceptable. Regarding the duration of therapy, some experts recommend prolongation of TB treatment in certain HIV-positive patients.[4]
Patients Taking ART
Extrapulmonary
Tuberculous Lymphadenitis
Skeletal Tuberculosis
Tuberculous Meningitis
Miliary Tuberculosis
Tuberculosis Peritonitis
Tuberculous Pericarditis
Renal Tuberculosis
Liver Disease
Referencies
- ↑ Harries AD, Zachariah R, Lawn SD (2009). "Providing HIV care for co-infected tuberculosis patients: a perspective from sub-Saharan Africa". Int J Tuberc Lung Dis. 13 (1): 6–16. PMID 19105873.
- ↑ Khan FA, Minion J, Pai M, Royce S, Burman W, Harries AD; et al. (2010). "Treatment of active tuberculosis in HIV-coinfected patients: a systematic review and meta-analysis". Clin Infect Dis. 50 (9): 1288–99. doi:10.1086/651686. PMID 20353364.
- ↑ 3.0 3.1 "2013 WHO Treatment of Tuberculosis: Guidelines for National Programmes (4th Edition)".
- ↑ "Treatment of tuberculosis".