The utility of nucleos(t)ide-only regimens in the treatment of Mycobacterium tuberculosis–HIV-1 coinfection

Abstract

HIV-tuberculosis coinfection is complex partly because rifamycins reduce therapeutic levels of protease inhibitors and nonnucleoside reverse transcriptase inhibitors, leading to potential virological failure. One therapeutic option is to use nucleos(t)ide-only regimens that have minimal interactions with antituberculous therapy. We report the largest published series of HIV-tuberculosis coinfected patients successfully treated with nucleos(t)ide regimens and antituberculous therapy. This group achieved similar virological and immunological outcomes when compared with tuberculosis patients on nonnucleoside reverse transcriptase inhibitor or protease inhibitor-based HAART, demonstrating the utility of this approach.