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Treatment of pulmonary tuberculosis in HIV-infected adults: Follow-up after initiation of therapy

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

INTRODUCTION

The approach to monitoring the human immunodeficiency virus (HIV)-infected patient on antituberculous medications must include consideration of the antituberculous regimen, the antiretroviral therapy regimen, potential drug reactions, and complications related to the immune reconstitution inflammatory syndrome (IRIS).

This topic will cover the issues related to monitoring of HIV-infected patients with tuberculosis (TB), including directly observed therapy, the clinical response to treatment, adverse events related to treatment, duration of treatment, and prognosis.

Issues related to clinical manifestations, diagnosis, and treatment of susceptible TB in HIV-infected patients are discussed elsewhere. (See "Epidemiology, clinical manifestations, and diagnosis of tuberculosis in HIV-infected patients" and "Treatment of pulmonary tuberculosis in HIV-infected adults: Initiation of therapy".)

INITIATION OF THERAPY

Issues related to selection of antituberculous therapy and antiretroviral therapy are discussed separately. (See "Treatment of pulmonary tuberculosis in HIV-infected adults: Initiation of therapy".)

DURATION OF THERAPY

The standard duration of therapy for treatment of drug-susceptible pulmonary TB in HIV-infected patients on antiretroviral therapy (ART) is six months. This includes an intensive phase of four drugs (isoniazid, a rifamycin [eg, rifampin or rifabutin], pyrazinamide, and ethambutol) administered for two months, followed by a continuation phase of two drugs (isoniazid and a rifamycin) administered for four months [1,2].

             
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Literature review current through: Nov 2017. | This topic last updated: Nov 09, 2017.
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