Jul 15, 2009
Response from Dr. Sherer
Yes. This is an important question to discuss with your doctor, but, in general, when a patient on ART is diagnosed with a new opportunistic infection, it is recommended that they continue on ART while they are treated for the infection.
You may be asking because there is some uncertainty about the best way in which to START treatment of HIV and active TB when they are diagnosed for the first time at the same time. In this setting, there are some reasons to first treat the TB, for as short a time as 2 weeks, or, in some cases, for a longer time, e.g. 2 months, or even after the TB treatment is completed after 9 months.
But in your case, when you are already receiving ART and have been newly diagnosed with TB, it is standard practice to continue ART while treating the TB.
You can also talk to your doctor at the same time about the role of ART, if any, in your new TB. Sometimes the improvement of the immune system on ART - called immune reconstitution - can lead to new clinical syndromes, the so called Immune Reconstitution Inflammatory Syndromes (IRIS). You can ask your doctor whether that is present in your case, and the kinds of additional treatments that may be used. For example, corticosteroids are sometimes necessary to reduce the inflammation that is associated with IRIS. You may also receive corticosteroids for TB meningitis as well.
I urge you to talk to your doctor about your questions and these responses.
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