Division of Clinical Pharmacology, Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Clin Pharmacol Ther. 2018 Dec;104(6):1098-1109. doi: 10.1002/cpt.1221. Epub 2018 Oct 26.
Children and pregnant and postpartum women experience an undue burden of HIV-associated tuberculosis (TB), but data are lacking on key aspects of their complex management. Often excluded from clinical trials, they are left with limited options for HIV-TB cotreatment. This review will focus on pharmacologic aspects of the treatment of HIV-TB coinfection in the special populations of children and pregnant and postpartum women. Pharmacogenomic considerations, rational dosing, drug-drug interactions, safety, immune reconstitution inflammatory syndrome, and ethical and policy aspects of the inclusion of special populations in research will be surveyed. Considerations related to the treatment of both HIV-associated TB disease and HIV-associated latent TB infection will be summarized. Relevant knowledge gaps and research priorities in special populations will be outlined.
儿童、孕妇和产后妇女感染艾滋病毒相关结核病（TB）的负担不成比例，但他们复杂管理的关键方面的数据却很缺乏。他们经常被排除在临床试验之外，因此可供他们选择的 HIV-TB 联合治疗方案有限。本综述将重点关注儿童、孕妇和产后妇女这两个特殊人群中 HIV-TB 合并感染的治疗中的药理学方面。将对药物基因组学考虑因素、合理剂量、药物相互作用、安全性、免疫重建炎症综合征以及将特殊人群纳入研究的伦理和政策方面进行调查。将总结与 HIV 相关的 TB 疾病和 HIV 相关的潜伏性 TB 感染治疗相关的注意事项。将概述特殊人群中相关的知识空白和研究重点。
