Least potent of first-line agents but must be in regimen until susceptibilities are known. Visual/color acuity testing needed if continued long term.
Hepatotoxicity, hyperuricemia possible.
Important for 6-month "short-course" therapy. Many drug interactions. May cause LFT abnormalities, especially cholestatic picture.
Hepatotoxicity, peripheral neuropathy possible; risk of latter decreased with the use of pyridoxine (vitamin B6).
Comment: Current guidance for drug-susceptible and therefore more straightforward cases.
Comment: Focus on regimens and some approaches with drug resistance.
Comment: For MDR-TB (resistance to at least INH + RIF), two types of regimens are possible: 9-12 months (shorter) or 18-20 months (longer).
Comment: Update on TB treatment, both drug-susceptible and drug-resistant disease.
Comment: Molecular methods are revolutionizing diagnosis, although TB remains especially difficult in some settings, e.g., CSF.
Comment: Early ART initiation (within 4 weeks vs. 8-12 weeks after starting TB therapy) was not associated with a decreased risk of the combined endpoint of AIDS or death among all study participants, but was associated with a decreased risk among persons with CD4 < 50.
Comment: This study was open to patients with CD4 < 200, but the median CD4 count was only 25. Early ART initiation (within 2 weeks vs. 8 weeks after starting TB therapy) was associated with a decreased risk of death.
Comment: Similar to the results of the study by Abdool Karim, early ART initiation (within 2 weeks vs. 8-12 weeks after starting TB therapy) was not associated with a decreased risk of the combined endpoint of AIDS or death among all study participants, but was associated with a decreased risk among persons with CD4 < 50.
Comment: Xpert MTB/RIF test 98% sensitive in smear-positive patients and 90% sensitive in smear-negative patients if 3 tests performed. 99% specific. Not FDA-approved.
Comment: CDC guidelines for use of interferon gamma release assays.
Comment: Recommendation that nucleic acid amplification testing be performed on at least one respiratory specimen from patients with signs and symptoms of pulmonary TB for whom the test result would alter case management or TB control (e.g., contact investigations).
Comment: Genotype MTBDR (Hain Lifescience) test to detect TB, as well as INH and RIF resistance.
Comment: Recommendations for use of rifampin and rifabutin with antiretroviral therapy, including integrase inhibitors, non-nucleoside reverse transcriptase inhibitors, and protease inhibitors.
Updated regularly on-line:https://aidsinfo.nih.gov/guidelines/html/4/adult-and-adolescent-oi-prevention-and-treatment-guidelines/0
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