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 |
Recommendation |
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
- Page last updated: December 9, 2013
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