"Tuberculosis and HIV Infection"

Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.

"Tuberculosis and HIV Infection"

New England Journal of Medicine (12/26/91) Vol. 325, No. 26, P. 1882
Di Perri, Giovanni

Abstract: Chemoprophylaxis should be continued past the usual 12 months for treating tuberculosis, write Giovanni Di Perri and colleagues of the Universities of Verona and Trento, Italy. In the June 6 edition of The New England Journal of Medicine, Bartnes et al. concluded their review of tuberculosis and HIV infection by stating that 12 months of chemoprophyylaxis with isoniazid should be administered to HIV-infected subjects with positive tuberculin skin tests, despite immunologic status. This policy is based on the observation that M. tuberculosis is believed to be reactivated earlier than other microbial pathogens linked to AIDS, such as Pneumocystis carinii and Toxoplasma gondii. But because isoniazid is unlikely to destroy the organisms, the policy is not effective. Depression of cell-mediated immunity progresses over time, therefore the risk of a reactivation of latent tuberculosis infection becomes greatest in the latter course of HIV-infection, usually after the 12-month course of isoniazid chempoprophylaxis is completed, the researchers conclude.

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