Are We There Yet? Short-Course Regimens in TB and HIV: From Prevention to Treatment of Latent to XDR TB

Curr HIV/AIDS Rep. 2020 Dec;17(6):589-600. doi: 10.1007/s11904-020-00529-8.

Abstract

Purpose of review: Despite broad uptake of antiretroviral therapy (ART), tuberculosis (TB) incidence and mortality among people with HIV remain unacceptably high. Short-course regimens for TB, incorporating both novel and established drugs, offer the potential to enhance adherence and completion rates, thereby reducing the global TB burden. This review will outline short-course regimens for TB among patients with HIV.

Recent findings: After many years without new agents, there is now active testing of many novel drugs to treat TB, both for latent infection and active disease. Though not all studies have included patients with HIV, many have, and there are ongoing trials to address key implementation challenges such as potent drug-drug interactions with ART. The goal of short-course regimens for TB is to enhance treatment completion without compromising efficacy. Particularly among patients with HIV, studying these shortened regimens and integrating them into clinical care are of urgent importance. There are now multiple short-course regimens for latent infection and active disease that are safe and effective among patients with HIV.

Keywords: Drug-drug interactions; Drug-resistant tuberculosis; Drug-susceptible tuberculosis; HIV infection; Tuberculosis; Tuberculosis preventive therapy.

Publication types

  • Review

MeSH terms

  • Anti-HIV Agents / therapeutic use*
  • Antitubercular Agents / therapeutic use*
  • Drug Interactions
  • Extensively Drug-Resistant Tuberculosis / drug therapy*
  • HIV Infections / drug therapy*
  • Humans
  • Isoniazid / therapeutic use
  • Pyrazinamide / therapeutic use
  • Rifampin / analogs & derivatives
  • Rifampin / therapeutic use
  • Tuberculosis, Pulmonary / drug therapy*

Substances

  • Anti-HIV Agents
  • Antitubercular Agents
  • Pyrazinamide
  • Isoniazid
  • Rifampin
  • rifapentine