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Tuberculosis — SCE Infectious Diseases MCQ

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HardHIV MedicineTuberculosisSCE Infectious Diseases

A person with HIV requires ritonavir-boosted darunavir because archived resistance leaves no fully active INSTI regimen. Rifamycin-susceptible pulmonary TB is diagnosed. Which strategy permits effective treatment of both infections?

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Correct answer: B — Use rifabutin-based TB treatment with adjusted rifamycin and boosted-darunavir dosing under specialist monitoring

Rifampicin induction makes co-administration with a ritonavir-boosted protease inhibitor ineffective and potentially unsafe. BHIVA recommends rifabutin-based TB treatment when an effective ART regimen necessarily contains a ritonavir-boosted PI. Dosing and toxicity monitoring require specialist HIV/TB and pharmacy input.

Reference: BHIVA TB/HIV guideline: https://bhiva.org/clinical-guideline/TB-guidelines/