Abstract
Children and pregnant and postpartum women experience an undue burden of HIV-associated tuberculosis (TB), but data are lacking on key aspects of their complex management. Often excluded from clinical trials, they are left with limited options for HIV-TB cotreatment. This review will focus on pharmacologic aspects of the treatment of HIV-TB coinfection in the special populations of children and pregnant and postpartum women. Pharmacogenomic considerations, rational dosing, drug-drug interactions, safety, immune reconstitution inflammatory syndrome, and ethical and policy aspects of the inclusion of special populations in research will be surveyed. Considerations related to the treatment of both HIV-associated TB disease and HIV-associated latent TB infection will be summarized. Relevant knowledge gaps and research priorities in special populations will be outlined.
© 2018 American Society for Clinical Pharmacology and Therapeutics.
MeSH terms
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Age Factors
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Anti-HIV Agents / adverse effects
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Anti-HIV Agents / pharmacokinetics
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Anti-HIV Agents / therapeutic use*
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Antitubercular Agents / adverse effects
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Antitubercular Agents / pharmacokinetics
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Antitubercular Agents / therapeutic use*
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Child
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Child, Preschool
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Clinical Decision-Making
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Coinfection*
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Female
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HIV / drug effects*
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HIV / immunology
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HIV / pathogenicity
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HIV Infections / drug therapy*
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HIV Infections / epidemiology
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HIV Infections / immunology
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HIV Infections / transmission
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Host-Pathogen Interactions
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Humans
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Infant
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Infant, Newborn
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Infectious Disease Transmission, Vertical / prevention & control*
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Male
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Mycobacterium tuberculosis / drug effects*
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Mycobacterium tuberculosis / immunology
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Mycobacterium tuberculosis / pathogenicity
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Pregnancy
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Pregnancy Complications, Infectious / drug therapy*
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Pregnancy Complications, Infectious / epidemiology
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Pregnancy Complications, Infectious / immunology
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Risk Factors
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Treatment Outcome
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Tuberculosis / drug therapy*
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Tuberculosis / epidemiology
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Tuberculosis / immunology
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Tuberculosis / transmission
Substances
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Anti-HIV Agents
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Antitubercular Agents