Problems and suggestions in the treatment of TB/HIV coinfection

doi:10.3969/j.issn.2096-8493.2020.01.004

Abstract

Abstract:

AIDS complicated with tuberculosis (TB) has become a serious public health problem in China. The mortality rate of TB/HIV co-infection is higher than that of HIV-negative TB patients. The treatment process involves anti-TB and anti-HIV treatment. Anti-TB and anti-HIV treatment are faced with serious challenges due to the initiation time of antiviral therapy, drug interactions, drug tolerance, the prevention and treatment of TB-associated immune reconstitution syndrome. The author discusses the latest research on the treatment and management of patients with TB/HIV co-infection, combined with literature and clinical experience.

Key words: Tuberculosis, HIV infections, Superinfection, Episode of care, Problem-based learning

WU Gui-hui, HUANG Tao. Problems and suggestions in the treatment of TB/HIV coinfection[J]. Journal of Tuberculosis and Lung Disease , 2020, 1(1): 11-16. doi: 10.3969/j.issn.2096-8493.2020.01.004

Figures/Tables 1

References 28

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抗病毒药品	异烟肼	乙胺丁醇	吡嗪酰胺	利福布汀	利福平	备注
阿巴卡韦 (abacavir)	+	+	+	+	±	利福平增加了葡萄糖醛酸化作用,阿巴卡韦暴露量轻微减少,剂量无需调整
依非韦伦 (efavirenz)	+	+	+	±	±	利福平剂量不变,利福布汀450~600mg/次,1次/d
埃替拉韦/考比司他 (elvitegravir/c)	+	+	+	±	?	考比司他与利福平为禁忌;与利福布汀联用减量至150mg/次,隔日1次
拉米夫定 (lamivudine)	+	+	+	+	+
洛匹那韦/利托那韦 (lopinavir/r)	+	+	+	±	?	与利福平配伍禁忌;利福布汀剂量调整为150mg/次,1次/d
奈韦拉平 (nevirapine)	+	+	+	±	?	与利福布汀合用剂量不变
拉替拉韦 (raltegravir)	+	+	+	+	±	与利福平联用时,拉替拉韦剂量调整为800mg/次,2次/d
利匹韦林 (rilpivirine)	+	+	+	±	?	与利福布汀避免联合使用,如非必要,则利匹韦林调整剂量为50mg/次,1次/d,同时警惕Q-T间期延长风险
替诺福韦 (tenofovir)	+	+	+	+	+
齐多夫定 (zidovudine)	+	+	+	+	±	利福平增加齐多夫定的清除率,减少47%的血浆暴露量
马拉维罗 (maraviroc)	+	+	+	±	±	利福平降低马拉韦罗克暴露60%~70%,与利福平合用时剂量调整为600mg/次,2次/d;与利福布汀合用时剂量不调整