Tuberculosis medical therapy special conditions: Difference between revisions

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Depending on the treatment status of each patient, 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>
Depending on the treatment status of each patient, 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 [[antiretroviral therapy]] ([[ART]]), the priority is to initiate treatment for TB, along with [[co-trimoxazole]] and [[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.<ref name="pmid20353364">{{cite journal| author=Khan FA, Minion J, Pai M, Royce S, Burman W, Harries AD et al.| title=Treatment of active tuberculosis in HIV-coinfected patients: a systematic review and meta-analysis. | journal=Clin Infect Dis | year= 2010 | volume= 50 | issue= 9 | pages= 1288-99 | pmid=20353364 | doi=10.1086/651686 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20353364  }} </ref><ref name="WHO 2013"> {{cite web|  url=http://www.who.int/tb/publications/tb_treatmentguidelines/en/| title=2013 WHO Treatment of Tuberculosis: Guidelines for National Programmes (4th Edition) }}</ref>
* 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.<ref name="pmid20353364">{{cite journal| author=Khan FA, Minion J, Pai M, Royce S, Burman W, Harries AD et al.| title=Treatment of active tuberculosis in HIV-coinfected patients: a systematic review and meta-analysis. | journal=Clin Infect Dis | year= 2010 | volume= 50 | issue= 9 | pages= 1288-99 | pmid=20353364 | doi=10.1086/651686 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20353364  }} </ref><ref name="WHO 2013"> {{cite web|  url=http://www.who.int/tb/publications/tb_treatmentguidelines/en/| title=2013 WHO Treatment of Tuberculosis: Guidelines for National Programmes (4th Edition) }}</ref>


According to the WHO, the following recommendations should be applied to these patients:
According to the WHO, the following recommendations should be applied to these patients:
#''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 Taking ART===
===Patients Taking ART===

Revision as of 19:34, 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:

  1. 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 Taking ART

Further information: HIV coinfection with tuberculosis

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Referencies

  1. ↑ 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.
  2. ↑ 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. ↑ "2013 WHO Treatment of Tuberculosis: Guidelines for National Programmes (4th Edition)".

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