[Tuberculosis among HIV-infected persons in Norway]

HIV-infected persons have a considerably higher risk of developing active tuberculosis than immunocompetent individuals. Tuberculosis is the only opportunistic infection among HIV-infected persons that presents a potential health risk to the general population.

We present a review on this topic based on relevant literature and clinical experience.

Treatment options are limited because of interactions between rifamycins and protease inhibitors and non-nucleoside analogues. When concomitant therapy against HIV infection and tuberculosis is indicated, we suggest a first-line regimen of rifabutin combined with either indinavir or nelfinavir. For patients without severe immunodeficiency, anti-retroviral therapy can be postponed until the end of the initial phase of the anti-tuberculosis treatment.

Treatment of concurrent HIV infection and tuberculosis is complex and may involve multiple drug regimens. Treating the latent infection could in many cases prevent active tuberculosis. All HIV-infected persons should be evaluated with respect to active tuberculosis and latent infection.