Tuberculosis medical therapy special conditions

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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 an HIV-positive patient, 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 the incidence of TB relapse and resistance to rifampicin , often seen in HIV-positive patients.[2][3]

Patients Taking ART

Extrapulmonary

Tuberculous Lymphadenitis

Skeletal Tuberculosis

Tuberculous Meningitis

Miliary Tuberculosis

Tuberculosis Peritonitis

Tuberculous Pericarditis

Renal Tuberculosis

Liver Disease

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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