State‐of‐the‐Art Review of <scp>HIV</scp>‐<scp>TB</scp> Coinfection in Special Populations

Weld, Ethel D.; Dooley, Kelly E.

doi:10.1002/cpt.1221

Cited by 17 publications

(18 citation statements)

References 74 publications

(122 reference statements)

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“…Furthermore, this is a particular concern in children and pregnant women, who are frequently excluded from clinical trials. Within this issue, Weld and Dooley discuss the gaps in knowledge in the dosing, efficacy, and safety of many new or first line antituberculosis drugs as well as their impact on antiretroviral agents in these populations. The possibility of clinically important drug‐drug interactions with these agents is high and physiological differences in pregnancy or infancy can further exacerbate safety or efficacy difficulties.…”

Section: Barriers To Successful Treatmentmentioning

confidence: 99%

Battling the HIV/AIDS Epidemic: Triumphs and Barriers

McColl

Kojovic

Piquette-Miller

2018

Clin Pharma and Therapeutics

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Worldwide, over 77 million people have been infected by human immunodeficiency virus (HIV) but its cure remains elusive. Once considered a fatal disease, advances in antiretroviral therapy (ART) have dramatically increased the life expectancy of infected persons. Much progress has been made in the development and utilization of combination ART and preventative pre‐exposure prophylaxis products, however, numerous obstacles prevent eradication. Clinical pharmacologists along with world health organizations continue to play a key role in identifying and implementing strategies to combat this disease.

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Section: Barriers To Successful Treatmentmentioning

confidence: 99%

Battling the HIV/AIDS Epidemic: Triumphs and Barriers

McColl

Kojovic

Piquette-Miller

2018

Clin Pharma and Therapeutics

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“…The knowledge gap persists in children under the age of three years: with the use of LPV/r in first line regimens (efavirenz cannot be given), options are very limited for rifamycin‐based TPT . A dosing recommendation for dolutegravir with rifampicin cannot yet be made.…”

Section: Discussionmentioning

confidence: 99%

New opportunities in tuberculosis prevention: implications for people living with HIV

et al. 2020

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Introduction Tuberculosis (TB) is a leading cause of mortality among people living with HIV (PLHIV). An invigorated global END TB Strategy seeks to increase efforts in scaling up TB preventive therapy (TPT) as a central intervention for HIV programmes in an effort to contribute to a 90% reduction in TB incidence and 95% reduction in mortality by 2035. TPT in PLHIV should be part of a comprehensive approach to reduce TB transmission, illness and death that also includes TB active case‐finding and prompt, effective and timely initiation of anti‐TB therapy among PLHIV. However, the use and implementation of preventive strategies has remained deplorably inadequate and today TB prevention among PLHIV has become an urgent priority globally. Discussion We present a summary of the current and novel TPT regimens, including current evidence of use with antiretroviral regimens (ART). We review challenges and opportunities to scale‐up TB prevention within HIV programmes, including the use of differentiated care approaches and demand creation for effective TB/HIV services delivery. TB preventive vaccines and diagnostics, including optimal algorithms, while important topics, are outside of the focus of this commentary. Conclusions A number of new tools and strategies to make TPT a standard of care in HIV programmes have become available. The new TPT regimens are safe and effective and can be used with current ART, with attention being paid to potential drug‐drug interactions between rifamycins and some classes of antiretrovirals. More research and development is needed to optimize TPT for small children, pregnant women and drug‐resistant TB (DR‐TB). Effective programmatic scale‐up can be supported through context‐adapted demand creation strategies and the inclusion of TPT in client‐centred services, such as differentiated service delivery (DSD) models. Robust collaboration between the HIV and TB programmes represents a unique opportunity to ensure that TB, a preventable and curable condition, is no longer the number one cause of death in PLHIV.

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“…The care of HIV-infected TB patients and the optimal use and timing of ART during TB treatment has dramatically evolved in recent years [57]. Treatment outcome in HIV-infected patients is highly influenced by proper management of ART, including a recognition of potential interactions between some antiretrovirals and TB drugs, particularly the rifamycins [58].…”

Section: How Can We Include Vulnerable Populations Such As Childrenmentioning

confidence: 99%