Tables
- Table. 1—
Antiretroviral treatment for individuals with tuberculosis (TB) taking rifampicin-containing regimens
CD4+ lymphocyte count Recommendations <200 cells·mm−3# Start TB treatment and one of the following regimens as soon as TB treatment is tolerated (between 2 weeks and 2 months): ZDV¶/3TC/EFV+,§ ZDV¶/3TC/ABCƒ ZDV¶/3TC/SQV/RTV (400/400 mg twice daily)ƒ ZDV¶/3TC/SQV/r (1600/200 mg daily in soft-gel capsule) ZDV¶/3TC/LPV/RTV (400/400 mg twice daily) ZDV¶/3TC/NVP## 200–350 cells·mm−3 Start TB treatment and one of above-listed regimens after 2 months of TB treatment, unless the individual is severely ill NVP-containing regimen can be used in case of non-rifampicin-based continuation phase >350 cells·mm−3 Start and complete TB treatment; start ART after completion, as if not on rifampicin, unless other stage IV conditions are present, in which case earlier ART introduction needs to be considered Not available Start TB treatment; in extrapulmonary TB, start antiretroviral treatment as soon as TB treatment is tolerated (2 weeks to 2 months); if no other stage IV conditions are present, start ART after TB treatment has been completed, as if not on rifampicin ZDV: zidovudine 300 mg twice daily; 3TC: lamivudine 150 mg twice daily or 300 mg once daily; EFV: efavirenz; ABC: abacavir 300 mg twice daily; SQV/RTV: saquinavir/ritonavir (boosted protease inhibitor); SQV/r: saquinavir (soft-gel capsule)/ritonavir; LPV/RTV: lopinavir/ritonavir (boosted protease inhibitor); NVP: nevirapine 200 mg once daily for initial 2 weeks, thereafter 200 mg twice daily; ART: antiretroviral treatment. #: in extrapulmonary TB, antiretroviral treatment should be started as soon as TB treatment is tolerated, irrespective of CD4+ lymphocyte count; ¶: can be replaced by stavudine 40 mg twice daily (if <60 kg, 30 mg twice daily); +: dose of efavirenz may need to be increased from 600 mg to 800 mg per day; §: contraindicated in pregnancy; ƒ: recommended for pregnant females or females of childbearing age without effective contraception; ##: owing to limited data on the appropriate increased dose of NVP to be used when using a rifampicin-based regimen, this should be used only as a last resort; can be used for rifampicin-free tuberculosis treatment regimens. Adapted from 24.
- Table. 2—
Essential components of the expanded directly observed treatment, short-course (DOTS) strategy for control of tuberculosis
Sustained political commitment to make tuberculosis control an integral priority of the national health system Access to quality-assured tuberculosis sputum microscopy for case detection among symptomatic individuals and high-risk groups, such as household contacts and HIV-infected individuals Standard short-course chemotherapy for all tuberculosis cases under proper case-management conditions, including direct observation of treatment Uninterrupted supply of quality-assured drugs with reliable procurement and distribution systems Recording and reporting system enabling outcome assessment of all patients and assessment of overall programme performance Adapted from 16.
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- Article
- Abstract
- THE EPIDEMIOLOGICAL LINK BETWEEN HIV AND TUBERCULOSIS
- CLINICAL PRESENTATION OF TUBERCULOSIS IN HIV-INFECTED AND -UNINFECTED INDIVIDUALS
- TUBERCULOSIS TREATMENT IN HIV-INFECTED PATIENTS WHO ARE NOT RECEIVING ANTIRETROVIRAL DRUG TREATMENT
- TREATMENT OF TUBERCULOSIS IN HIV-INFECTED PATIENTS STARTING OR ALREADY TAKING ANTIRETROVIRAL DRUGS
- PRINCIPLES OF EFFECTIVE TUBERCULOSIS CONTROL
- PREVENTION AND CONTROL OF HIV-RELATED TUBERCULOSIS
- CONCLUSION
- Footnotes
- References
- Figures & Data
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