Beruflich Dokumente
Kultur Dokumente
Session Objectives
• Explain the relationship between HIV & TB
• Describe the epidemiology of HIV & TB on a
global and Indian scale
• List the manifestations of TB in different
stages of HIV
• Determine the appropriate time to initiate a
regimen for treatment of TB in HIV-positive
patients
• Describe how to appropriately manage ARV
treatment for a co-infected patient
Source: NACO, ND
HIV
TB Infection
Infection 39.5 million
14
Million
0
0-100 47
After
6
Months
Courtesy of: GHTM, Chennai, 2004
ZIDOVUDINE
NEVIRAPINE
OR + LAMIVUDINE + OR
STAVUDINE
EFAVIRENZ
Drug Interactions
• Rifampicins stimulate cytochrome P450 liver
enzyme system that metabolizes PIs and
NNRTIs
• Protease inhibitors and NNRTIs can enhance or
inhibit this system leading to altered blood
levels of Rifampicin
• Rifampicin significantly reduced bioavailability
of Nevirapine and the C min to sub-therapeutic
levels in 62% of patients