| アブストラクト | Bedaquiline, a potent new therapy for drug-resistant tuberculosis, results in improved survival including in HIV patients with multidrug and extensively drug-resistant tuberculosis. In line with WHO recommendations, in South Africa and other low-income and middle-income settings, antiretroviral therapy is switched from generic fixed-dose combination efavirenz-containing regimens to twice-daily nevirapine with separate companion pills because of interactions between efavirenz and bedaquiline. Early data suggest a signal for low antiretroviral therapy adherence after this antiretroviral therapy switch. Mortality and other tuberculosis-specific benefits noted with bedaquiline treatment in multidrug and extensively drug-resistant tuberculosis HIV might be compromised by HIV viral failure, and emergent antiretroviral resistance. Programmatic responses, such as adherence support and dual pharmacovigilance, should be instituted; antiretroviral therapy initiation with fixed-dose combinations without bedaquiline drug interactions should be strongly considered. |
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| 投稿者 | O'Donnell, Max R; Padayatchi, Nesri; Daftary, Amrita; Orrell, Catherine; Dooley, Kelly E; Rivet Amico, K; Friedland, Gerald |
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| 組織名 | Division of Pulmonary, Allergy, and Critical Care Medicine, and Department of;Epidemiology, Mailman School of Public Health, Columbia University Medical;Center, New York, NY, USA; CAPRISA MRC-HIV-TB Pathogenesis and Treatment Research;Unit, Durban, South Africa. Electronic address: mo2130@columbia.edu.;CAPRISA MRC-HIV-TB Pathogenesis and Treatment Research Unit, Durban, South;Africa.;Africa; McGill International TB Centre and Department of Epidemiology,;Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.;Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa.;Division of Clinical Pharmacology and Infectious Diseases, Center for;Tuberculosis Research, Department of Medicine, Johns Hopkins University,;Baltimore, MD, USA.;School of Public Health, University of Michigan, Ann Arbor, MI, USA.;Yale School of Medicine, New Haven, CT, USA. |
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