Evidence for Implementation: Management of TB in HIV and Pregnancy.
Amanda J JonesJyoti S MathadKelly E DooleyAhizechukwu C EkePublished in: Current HIV/AIDS reports (2022)
This review discusses the currently available evidence on the use of anti-TB agents in pregnant PLWH on ART. Pharmacokinetic and safety studies of anti-TB agents during pregnancy and postpartum are limited, and available data on second-line and newer anti-TB agents used in pregnancy suggest that several research gaps exist. DDIs between ART and anti-TB agents can decrease plasma concentration of ART, with the potential for perinatal transmission of HIV. Current recommendations for the treatment of LTBI, drug-susceptible TB, and multidrug-resistant TB (MDR-TB) are derived from observational studies and case reports in pregnant PLWH. While the use of isoniazid, rifamycins, and ethambutol in pregnancy and their DDIs with various ARTs are well-characterized, there is limited data on the use of pyrazinamide and several new and second-line antitubercular drugs in pregnant PLWH. Further research into treatment outcomes, PK, and safety data for anti-TB agent use during pregnancy and postpartum is urgently needed.
Keyphrases
- mycobacterium tuberculosis
- hiv infected
- antiretroviral therapy
- multidrug resistant
- pregnant women
- human immunodeficiency virus
- electronic health record
- hiv positive
- hepatitis c virus
- preterm birth
- healthcare
- primary care
- machine learning
- risk assessment
- pseudomonas aeruginosa
- cystic fibrosis
- quality improvement
- gram negative
- case report
- smoking cessation
- human health
- adverse drug