Managing Drug Interactions in the Treatment of HIV-Related Tuberculosis
Table 1b. Recommendations for regimens for the concomitant treatment of tuberculosis and HIV infection in children
|Combined regimen for treatment of HIV and tuberculosis||PK effect of the rifamycin||Tolerability / toxicity||Antiviral activity when used with rifampin||
|Super-boosted lopinavir-ritonavir‡ based ART with rifampin-containing tuberculosis treatment||Modest effect||Hepatitis||Early favorable experience of super-boosting among young children||Double dose lopinavir-ritonavir is not recommended|
|Efavirenz-based ART with rifampin-containing tuberculosis treatment||Well-characterized, modest effect||Low rates of discontinuation||Limited study; careful virologic monitoring recommended||Alternative for children >3 years (and >10 kg) for whom super-boosted lopinavir/ritonavir is not tolerated or is contraindicated.|
|Zidovudine / lamivudine / abacavir with rifampin-containing tuberculosis treatment||50% decrease in zidovudine, possible effect on abacavir not evaluated||Anemia||Early favorable experience, but this combination is less effective than efavirenz- or nevirapine-based regimens in adults not taking rifampin||Alternative for children <3 years or for patients for whom super- boosted lopinavir/ritonavir is not tolerated or is contraindicated|
‡ Super-boosting of lopinavir in children is achieved by giving standard-dose lopinavir/ritonavir plus additional ritonavir to achieve mg for mg parity of ritonavir and lopinavir.