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Co-treatment of Tuberculosis and HIV: Pharmacologic Considerations

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Abstract

Having HIV and TB worsens the impact of both. The treatment of HIV-TB coinfection is beset by challenges, including drug-drug-interactions, coincident toxicities, and the occurrence of the immune reconstitution inflammatory syndrome. These challenges can be overcome with careful attention to evidence-guided practice and clinical pharmacological aspects of co-treatment. There is a clear mortality benefit to treating both infections; the relative timing of initiation of both treatments will be discussed. This chapter will address pharmacologic considerations in the co-treatment of HIV-related latent or active TB of all sensitivity patterns (drug sensitive and multidrug resistant (MDR). The discussion will identify existing gaps in the evidence and include current recommendations for HIV-TB treatment in special populations, including pregnant and lactating women and children.

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Authors and Affiliations

  1. Divisions of Clinical Pharmacology & Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Ethel D. Weld & Kelly E. Dooley

  2. National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA

    Alice K. Pau

  3. Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa

    Gary Maartens

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  1. Ethel D. Weld
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  2. Alice K. Pau
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  3. Gary Maartens
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  4. Kelly E. Dooley
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Correspondence to Kelly E. Dooley .

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Editors and Affiliations

  1. National Institute of Health, National Institute of Allergy and Infectious Diseases, Bethesda, MD, USA

    Irini Sereti

  2. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Gregory P. Bisson

  3. Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, Department of Medicine, University of Cape Town, Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, Cape Town, South Africa

    Graeme Meintjes

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Weld, E.D., Pau, A.K., Maartens, G., Dooley, K.E. (2019). Co-treatment of Tuberculosis and HIV: Pharmacologic Considerations. In: Sereti, I., Bisson, G.P., Meintjes, G. (eds) HIV and Tuberculosis. Springer, Cham. https://doi.org/10.1007/978-3-030-29108-2_11

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