The risk of developing tuberculosis is much higher in people who are infected with human immunodeficiency virus [HIV].
HIV weakens the immune system, people that have both HIV and TB have a 40 percent higher risk of developing active, infectious TB than people who are not HIV positive.
Together both infections make each other worse.
TB makes HIV multiply faster and HIV helps TB become active.
It is very important for people that are HIV positive to be tested for TB. If infected you need to complete therapy as soon as possible.
However treatment of tubeculosis patients with HIV is complex.
The drugs used to treat TB and HIV can both cause damage to the liver and kidneys. Moreover there can be drug interactions between the medications when uses together.
The treatment of TB in HIV positive people must be very carefully planned and monitored.
The volume of problem of tuberculosis in HIV patients is staggering. For many people, tuberculosis may be the first sign of immune dysfunction associated with HIV. One in ten people living with HIV will get active TB within a year of being diagnosed with HIV. But the early HIV infection usually affects just the lungs.
However with further drop in CD4+ cell counts drop however, TB is more likely to appear in other organs too.
Testing for tuberculosis is recommended to begin when a person is first diagnosed with HIV, then yearly after that.
Drug Interactions
Rifampicin interacts with protease inhibitor (PI) and non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs.
The drug interactions are a concern and complex interactions between rifampicin and antiretroviral drugs may force withdrawal of conventional regimens. Rifabutin has been used as an alternative to rifampicin in such situations.
People taking the above mentioned classes of drugs should use rifabutin rather than rifampin for treating TB.
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