Latent Tuberculosis Treatment in HIV-Positive Patients: What’s New? Is It Overtreatment? Which One Is Preferred?
Arya Marganda Simanjuntak1, Ellya Catharine Lumbantoruan2, Merlinda Veronica3, Heri Ginting4, Anwar Sholeh4, Dani Rosidana4
1 Research Intern, Department of Internal Medicine, Faculty of Medicine, Universitas Riau, Arifin Achmad General Hospital
2 Faculty of Medicine, Universitas Tanjungpura, Pontianak, Indonesia
3 Tropical Infection Division, Department of Internal Medicine, Faculty of Medicine, Universitas Riau, Arifin Achmad General Hospital, Pekanbaru, Riau, Indonesia
4 Pulmonary and Critical Medicine Division, Department of Internal Medicine, Faculty of Medicine, Universitas Riau, Arifin Achmad General Hospital, Pekanbaru, Riau, Indonesia
Corresponding Author : Arya Marganda Simanjuntak, Dept of Internal Medicine, Faculty of Medicine, Universitas Riau, Arifin Achmad General hospital. arya.marganda@gmail.com
ABSTRACT
Latent Tuberculosis Infection (LTBI) is a focus especially in HIV-seropositive patients because immunocompromise increases the risk of reactivation of LTBI into active TB. Therefore, LTBI therapy was developed to prevent the TB from becoming active. However, several issues have been questioned regarding LTBI therapy in HIV patients as an overtreatment and potentially dangerous because both drugs in TB and HIV have the same profile of hepatotoxicity. This review comprehensively discusses existing regimens and current evidence on the management of LTBI in HIV patients. This should be taken into consideration, but we also see from recent studies that if a patient has TB activation in HIV, it will decrease treatment success and also increase morbidity and mortality. Therefore, LTBI therapy has been developed up to the latest prevention guideline in 2024 with fewer treatment regimens than Active TB with 3HP or 3 HR. While it can be argued that LTBI therapy in HIV patients is necessary and not overtreatment, measures have also been developed to reduce the rate of hepatotoxicity that may occur.
Keywords : HIV, Latent Tuberculosis, Pharmacotherapy, Tuberculosis, Treatment
