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Notice to Readers: Updated Guidelines on Managing Drug Interactions in the Treatment of HIV-Related Tuberculosis

Guidelines for managing pharmacologic interactions that can result when patients receive antiretroviral drugs for treatment of human immunodeficiency virus (HIV) infection together with rifamycins for treatment of tuberculosis have been published previously (1--3). Updated guidelines, with recommendations from CDC and its partners, are now available at http://www.cdc.gov/tb/tb_hiv_drugs/default.htm.

The updated guidelines include recommendations for use of newer antiretroviral drugs, including those in new classes, such as CCR5 receptor antagonists and integrase inhibitors. The new guidelines provide additional recommendations regarding use of rifampin with antiretroviral therapy; these recommendations are critical in regions where rifabutin is unavailable. Changes from previous versions of these guidelines include 1) summaries of clinical experience with use of specific antiretroviral regimens during tuberculosis treatment (in addition to pharmacokinetic data), 2) a table summarizing clinical experience with key antiretroviral regimens and providing recommended regimens, and 3) sections on treatment for special populations (i.e., young children, pregnant women, and patients with drug-resistant tuberculosis). The online guidelines will be updated periodically to provide clinicians with the latest information.

References

  1. CDC. Prevention and treatment of tuberculosis among patients infected with human immunodeficiency virus: principles of therapy and revised recommendations. MMWR 1998;47(No. RR-20).
  2. CDC. Updated guidelines for the use of rifabutin or rifampin for the treatment and prevention of tuberculosis among HIV-infected patients taking protease inhibitors or nonnucleoside reverse transcriptase inhibitors. MMWR 2000;49:185--9.
  3. CDC. Updated guidelines for the use of rifamycins for the treatment of tuberculosis among HIV-infected patients taking protease inhibitors or nonnucleoside reverse transcriptase inhibitors. MMWR 2004;53:37.



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