Managing Drug Interactions in the Treatment of HIV-Related Tuberculosis

Return to Table of Contents

 

Table 1b. Recommendations for regimens for the concomitant treatment of tuberculosis and HIV infection in children

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 Recommendation
(comments)
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.

Page last reviewed: September 24, 2012