Tuberculosis medical therapy special conditions: Difference between revisions
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==HIV Coinfection== | ==HIV Coinfection== | ||
Depending on the treatment status of the patients, different approaches may be taken:<ref name="pmid19105873">{{cite journal| author=Harries AD, Zachariah R, Lawn SD| title=Providing HIV care for co-infected tuberculosis patients: a perspective from sub-Saharan Africa. | journal=Int J Tuberc Lung Dis | year= 2009 | volume= 13 | issue= 1 | pages= 6-16 | pmid=19105873 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19105873 }} </ref> | |||
===Patients Not Taking ART=== | ===Patients Not Taking ART=== | ||
* After the diagnosis of TB in an HIV-positive patient, not taking antiviral therapy, the priority is to initiate treatment for TB, along with co-trimoxazole and ART. | |||
* These patients should be treated with the same treatment regimen as non-HIV patients, with the exception that the intensive phase given 3 times/week is mandatory in HIV-positive patients. | |||
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However, the three times weekly intensive phase is no longer an option. This new recommendation is based on a systematic review showing that the incidence of relapse and failure among HIV-positive TB patients who were treated with intermittent TB therapy throughout treatment was 2–3 times higher than that in patients who received a daily intensive phase (17). In addition, a study in India showed that HIV-positive patients with pulmonary TB are at higher risk of acquired rifampicin resistance, when failing a three times weekly short-course intermittent regimen (18). | |||
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===Patients Taking ART=== | ===Patients Taking ART=== | ||
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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 the patients, different approaches may be taken:[1]
Patients Not Taking ART
- After the diagnosis of TB in an HIV-positive patient, not taking antiviral therapy, the priority is to initiate treatment for TB, along with co-trimoxazole and ART.
- These patients should be treated with the same treatment regimen as non-HIV patients, with the exception that the intensive phase given 3 times/week is mandatory in HIV-positive patients.
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.