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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
- 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).
- 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.
- 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.
Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of
Health and Human Services.
References to non-CDC sites on the Internet are
provided as a service to MMWR readers and do not constitute or imply
endorsement of these organizations or their programs by CDC or the U.S.
Department of Health and Human Services. CDC is not responsible for the content
of pages found at these sites. URL addresses listed in MMWR were current as of
the date of publication. |
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Date last reviewed: 1/30/2008
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