| Combined
regimen for treatment of HIV and tuberculosis |
PK effect
of the rifamycin |
Tolerability
/ toxicity |
Antiviral
activity when used with rifampin |
Recommendation(comments) |
| Efavirenz-based antiretroviral
therapy* with rifampin-based
TB treatment |
Well-characterized, modest effect |
Low rates of discontinuation |
Excellent |
Preferred (efavirenz should not
be used during the first trimester of pregnancy) |
| PI-based antiretroviral therapy* with rifabutin-based
TB treatment |
Little effect of rifabutin on
PI concentrations, but marked increases in rifabutin concentrations |
Low rates of discontinuation (if
rifabutin is appropriately dose-reduced) |
Favorable, though published clinical
experience is not extensive |
Preferred for patients unable
to take efavirenz † |
| Nevirapine-based antiretroviral
therapy with rifampin-based
TB treatment |
Moderate effect |
Concern about hepatotoxicity when
used with isoniazid, rifampin and pyrazinamide |
Favorable |
Alternative for patients who cannot
take efavirenz and if rifabutin not available |
| Zidovudine / lamivudine / abacavir
/ tenofovir with rifampin-based TB treatment10 |
50% decrease in zidovudine, possible
effect on abacavir not evaluated |
Anemia |
No published clinical experience |
Alternative for patients who cannot
take efavirenz and if rifabutin not available |
| Zidovudine / lamivudine / tenofovir
with rifampin-based TB treatment |
50% decrease in zidovudine, no
other effects predicted |
Anemia |
Favorable, but not evaluated in
a randomized trial |
Alternative for patients who cannot
take efavirenz and if rifabutin not available |
| Zidovudine / lamivudine / abacavir
with rifampin-based TB treatment |
50% decrease in zidovudine, possible
effect on abacavir not evaluated |
Anemia |
Early favorable experience, but
this combination is less effective than efavirenz-based regimens in persons
not taking rifampin |
Alternative for patients who cannot
take efavirenz and if rifabutin not available |
| Super-boosted lopinavir-based
ART with rifampin-based TB treatment |
Little effect |
Hepatitis among healthy adults,
but favorable experience, among young children (< 3 years) |
Good, among young children (<
3 years) |
Alternative if rifabutin not available;
preferred for young children when rifabutin not available |
