Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV
The information in the brief version is excerpted directly from the full-text guidelines. The brief version is a compilation of the tables and boxed recommendations.
Mycobacterium tuberculosis Infection and Disease
Last Updated: September 27, 2019; Last Reviewed: September 27, 2019
Treating LTBI to Prevent TB Disease
Treating Active TB Disease
Intensive Phase (2 Months):
Empiric Therapy for Resistance to Rifamycin plus/minus Resistance to Other Drugs:
Other Considerations in TB Management
|a Screening tests for LTBI include TST or IGRA; see text for details regarding these tests.
Key: ART = antiretroviral therapy; ARV = antiretroviral; CNS = central nervous system; DOT = directly observed therapy; EFV = efavirenz; IGRA = interferon-gamma release assay; LTBI = latent tuberculosis infection; NVP = nevirapine; PI = protease inhibitor; PO = orally; RAL = raltegravir; TB = tuberculosis; TST = tuberculin skin test
|TB Drug||ARV Drugs||Daily Dose|
|Isoniazid||All ARVs||5 mg/kg (usual dose 300 mg)|
Note: DTG, RAL, and MVC doses need to be adjusted when used with rifampin
|With HIV PIs, DOR, ETR, RPV, BIC, or EVG/c||Not recommended|
|With TAF||Use with cautionc at dose indicated below|
|With other ARV drugs||10 mg/kg (usual dose 600 mg)|
Note: DOR and RPV doses need to be adjusted when used with rifabutin
|With PI with COBI, TAF, BIC, or EVG/c - containing regimens||Not recommended|
|With DTG, RAL, EFV, DOR, RPV||5 mg/kg (usual dose 300 mg)|
|With HIV PIs with RTV||150 mgd|
|With EFV||450–600 mg|
|Pyrazinamide||All ARVs||Weight-Based Dosing
|Ethambutol||All ARVs||Weight-Based Dosing
|a For more detailed guidelines on use of different ARV drugs with rifamycin, clinicians should refer to the Drug-Drug Interactions section of the Adult and Adolescent Antiretroviral Guidelines
b Higher doses may be needed in the treatment of TB meningitis. Expert consultation is advised.
c This combination has not been tested in patients to confirm PK and virologic efficacy among patients taking full dose ART and TB regimens.
d Acquired rifamycin resistance has been reported in patients with inadequate rifabutin levels while on 150 mg twice weekly dosing together with RTV-boosted PIs. May consider TDM when rifabutin is used with an RTV-boosted PI and adjust dose accordingly.
e Monitor for therapeutic response and consider TDM to assure dosage adequacy in patients weighing >90 kg.
Key: ARV = antiretroviral; ART = antiretroviral therapy; BIC = bictegravir; COBI = cobicistat; DOR = doravirine; DTG = dolutegravir; EFV = efavirenz; ETR = etravirine; EVG = elvitegravir; EVG/c = elvitegravir/cobicistat; FTC = emtricitabine; MVC = maraviroc; PI = protease inhibitor; PK = pharmacokinetic; RAL = raltegravir; RPV = rilpivirine; RTV = ritonavir; TAF = tenofovir alafenamide; TB = tuberculosis; TDM = therapeutic drug monitoring
- CDC | 2015 STD Treatment Guidelines
- HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C
- AIDSinfo Patient Materials: What is an Opportunistic Infection?
- AIDSource | HIV-Related Conditions
- AETC National HIV Curriculum
- How to Cite These Guidelines
- Adult and Adolescent OI Guidelines Archive