IDSA Recommendations for Treating Mycobacterium Tuberculosis Infection and Disease in HIV-AIDS Treating LTBI (to prevent TB disease) Indications: • (+) screening test for LTBI, no evidence of active TB, and no prior history of treatment for active or latent TB • Close contact with a person with infectious TB, regardless of screening test result Preferred Therapy (Duration of Therapy = 9 Months): • INH 300 mg PO daily + pyridoxine 25-50 mg PO daily or • INH 900 mg PO twice weekly (by DOT) + pyridoxine 25-50 mg PO daily Alternative Therapies: • RIF 600 mg PO daily x 4 months or • RFB (dose adjusted based on concomitant ART) x 4 months or • RPT (weight-based, 900 mg max) PO weekly + INH 15 mg/kg weekly (900 mg max) + pyridoxine 50 mg weekly x 12 weeks – in patients receiving an EFV- or RAL-based ART regimen • For persons exposed to drug-resistant TB, select anti-TB drugs after consultation with experts or with public health authorities Treating Active TB Disease: • After collecting specimen for culture and molecular diagnostic tests, empiric treatment should be initiated in HIV-infected persons with clinical and radiographic presentation suggestive of HIV-related TB • DOT is recommended for all patients requiring treatment for HIV-related TB • Please refer to the table below for TB drug dosing recommendations and to the Adult and Adolescent ARV Guidelines for dosing recommendations of ARV drugs when used with RIF or RFB. #LTBI #Mycobacterium #Tuberculosis #TB #IDSA #Prevention #Treatment #management #opportunistic #infections #HIVAIDS #pharmacology
