Updated CDC Guidelines for Treating HIV-Related TB

Treatment of patients with HIV and tuberculosis (TB) is complicated by pharmacologic interactions between two multidrug regimens that have varying effects on the cytochrome P450 system. This problem is most profound in developing countries, where there is a high burden of coinfection and limited affordable pharmacologic options. New guidance for managing drug–drug interactions is now available from the CDC, with specific recommendations as follows.

Despite pharmacologic interactions, rifamycin treatment is highly efficacious and is recommended for the full course of TB therapy in all HIV-infected patients. The preferred combination of treatment for coinfected adults is efavirenz-based antiretroviral therapy with rifampin-based TB therapy, bo…