Combined antituberculosis and antiretroviral therapy in patients with tuberculosis concurrent with HIV infection
Abstract
Phthisiatrists and infectionists providing treatment of patients with co-infection (HIV and tuberculosis) are faced with several problems: how long the treatment should be, what kind of indications must be considered for beginning of the treatment and selection of effective and safe anti-tubercular and ARVT schemes. Today nobody is in doubt about that treatment of patients with active tuberculosis should be started with anti-tuberculosis treatment first. Still under discussion is the question of ARVT prescription for patients with co-infection HIV/tuberculosis still remains, when initial CD4+ lymphocytes count is > 350 cells/mkl (and especially >500 cells/mkl. The choice of ARVT starting scheme depends on initial number of CD4+ lymphocytes during development of tuberculosis and need of inclusion of rifampicin in the scheme anti-tuberculosis treatment, keeping in mind that use of it substantially narrow choice of ARV drugs. The replacement of rifampicin for rifabutin makes easier taking the decision about what scheme of ARVT should be. In this situation it is possible to prescribe the ARV drugs from the group of reverse-transcriptase inhibitors and from the groups of protease inhibitors or integrase inhibitor.
About the Authors
V. N. Zimina
ГКУЗ «Московский городской научно-практический центр борьбы с туберкулёзом Департамента здравоохранения города Москвы»
Russian Federation
Russian Federation
A. V. Kravchenko
ФБУН «Центральный НИИ эпидемиологии» Роспотребнадзора
Russian Federation
Russian Federation
V. A. Koshechkin
ФГБОУ ВПО «Российский университет дружбы народов»
Russian Federation
Russian Federation
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For citations:
Zimina V.N., Kravchenko A.V., Koshechkin V.A. Combined antituberculosis and antiretroviral therapy in patients with tuberculosis concurrent with HIV infection. Tuberculosis and socially significant diseases. 2013;(1):45-51. (In Russ.)
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