Treatment of TB in HIV positive patients

The standard treatment with quadruple therapy is effective.

Side-effects are more common in patients infected with HIV.

Incidence of bacterial pneumonia in HIV positive TB patients:

• rates of bacterial pneumonia are several times higher among HIV positive adults than in the general community
• in 1999 a randomised placebo controlled clinical trial in HIV positive patients with sputum smear positive pulmonary tuberculosis in Côte d'Ivoire found that co-trimoxazole prophylaxis significantly reduced mortality and morbidity
• a more recent study (1) found also found that prophylaxis with co-trimoxazole reduces mortality in HIV infected adults with pulmonary tuberculosis. Co-trimoxazole was generally safe and well tolerated

Reference:

• 1. Nunn AJ et al. UNZA-UCLMS Project LUCOT Collaboration. Role of co-trimoxazole prophylaxis in reducing mortality in HIV infected adults being treated for tuberculosis: randomised clinical trial. BMJ. 2008 Jul 10;337:a257.