Treatment Options for HIV-Associated Tuberculosis.
The vicious interaction between the human immunodeficiency virus (HIV) infection and tuberculosis (TB) pandemics poses special challenges to national control programs and individual physicians. Although recommendations for the treatment of TB in HIV-infected patients do not significantly differ from those for HIV-uninfected patients, the appropriate management of HIV-associated TB is complicated by health system issues, diagnostic difficulties, adherence concerns, overlapping adverse-effect profiles and drug interactions, and the occurrence of paradoxical reactions after the initiation of effective antiretroviral therapy. In this article, recommended treatment strategies and novel approaches to the management of HIV-associated TB are reviewed, including adjuvant treatment and options for treatment simplification. A focused research agenda is proposed in the context of the limitations of the current knowledge framework.
Onyebujoh
Philip Chukwuka
PC
United Nations Children's Fund/United Nations Development Programme/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases, Geneva, Switzerland. onyebujohp@who.int
Ribeiro
Isabela
I
Whalen
Christopher Curtis
CC
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D035843:Biomedical Research; D002986:Clinical Trials as Topic; D004334:Drug Administration Schedule; D006678:HIV; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D018977:Micronutrients / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014376:Tuberculosis / Q000150:complications* / Q000188:drug therapy*
D019380:Anti-HIV Agents; D000890:Anti-Infective Agents; D000995:Antitubercular Agents; D007155:Immunologic Factors; D018977:Micronutrients; D015662:Trimethoprim, Sulfamethoxazole Drug Combination