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Treatment of pulmonary tuberculosis in HIV-infected adults

Timothy R Sterling, MD
Section Editor
C Fordham von Reyn, MD
Deputy Editor
Elinor L Baron, MD, DTMH


The approach to the treatment of tuberculosis in the HIV-infected patient is complex and must address the patient's requirement for antiretroviral therapy (ART), potential drug reactions, and complications related to the immune reconstitution inflammatory syndrome [1,2].

This topic will address issues surrounding the care of the HIV-infected patient with tuberculosis (TB), with special attention to drug interactions between the rifamycins and the various classes of HIV medications. The clinical manifestations of TB disease in HIV-infected patients, monitoring on antituberculous medications, and the treatment of latent Mycobacterium tuberculosis infection are discussed separately. (See "Epidemiology, clinical manifestations, and diagnosis of tuberculosis in HIV-infected patients" and "Treatment of latent tuberculosis infection in HIV-infected adults" and "Monitoring the HIV-infected patient on antituberculous medications".)

Treatment of multidrug-resistant tuberculosis in HIV-infected patients is discussed elsewhere. (See "Diagnosis and treatment of extensively drug-resistant tuberculosis" and "Diagnosis, treatment, and prevention of drug-resistant tuberculosis".)

The clinician taking care of the HIV-infected patient with TB should be expert in HIV clinical management and treatment. The selection of ART regimens and the various antiretroviral drug classes for the treatment of HIV are discussed in detail elsewhere. (See "Selecting antiretroviral regimens for the treatment-naïve HIV-infected patient" and "Clinical trials of HIV antiretroviral therapy: CCR5 antagonists" and "Clinical trials of HIV antiretroviral therapy: Integrase inhibitors" and "Clinical trials of HIV antiretroviral therapy: Non-nucleoside reverse transcriptase inhibitors" and "Clinical trials of HIV antiretroviral therapy: Protease inhibitors" and "Clinical trials of HIV antiretroviral therapy: Protease inhibitors versus non-nucleoside reverse transcriptase inhibitors".)


The treatment of tuberculosis (TB) in the HIV-infected patient involves three basic components:


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Literature review current through: Sep 2016. | This topic last updated: Sep 21, 2016.
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