Initiating Antiretrovirals During Tuberculosis Treatment: a Drug Safety Review

Overview

Journal Expert Opin Drug Saf

Specialty Pharmacology

Date 2011 Jan 6

PMID 21204737

Citations 9

Authors

Tanuja N Gengiah

Andrew L Gray

Kogieleum Naidoo

Quarraisha Abdool Karim

Affiliations

Soon will be listed here.

Abstract

Introduction: Integrating HIV and tuberculosis (TB) treatment can reduce mortality substantially. Practical barriers to treatment integration still exist and include safety concerns related to concomitant drug use because of drug interactions and additive toxicities. Altered therapeutic concentrations may influence the chances of treatment success or toxicity.

Areas Covered: The available data on drug-drug interactions between the rifamycin class of anti-mycobacterials and the non-nucleoside reverse transcriptase inhibitor and the protease inhibitor classes of antiretrovirals are discussed with recommendations for integrated use. Additive drug toxicities, the impact of immune reconstitution inflammatory syndrome (IRIS) and the latest data on survival benefits of integrating treatment are elucidated.

Expert Opinion: Deferring treatment of HIV to avoid drug interactions with TB treatment or the occurrence of IRIS is not necessary. In the integrated management of TB-HIV co-infection, rational drug combinations aimed at reducing toxicities while effecting TB cure and suppressing HIV viral load are possible.

Citing Articles

Pharmacogenomic associations with HIV-1 virologic suppression in TB/HIV patients.

Ridolfi F, Amorim G, Haas D, Arriaga M, Staats C, Cordeiro-Santos M Res Sq. 2025; .

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A Comprehensive Review of HIV-Associated Tuberculosis: Clinical Challenges and Advances in Management.

Patel A, Pundkar A, Agarwal A, Gadkari C, Nagpal A, Kuttan N Cureus. 2024; 16(9):e68784.

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Addressing the Challenges of Tuberculosis: A Brief Historical Account.

Al-Humadi H, Al-Saigh R, Al-Humadi A Front Pharmacol. 2017; 8:689.

PMID: 29033842 PMC: 5626940. DOI: 10.3389/fphar.2017.00689.

Role of MRP transporters in regulating antimicrobial drug inefficacy and oxidative stress-induced pathogenesis during HIV-1 and TB infections.

Roy U, Barber P, Tse-Dinh Y, Batrakova E, Mondal D, Nair M Front Microbiol. 2015; 6:948.

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Tuberculosis Comorbidity with Communicable and Noncommunicable Diseases.

Bates M, Marais B, Zumla A Cold Spring Harb Perspect Med. 2015; 5(11).

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