Patients with HIV who also are

Patients with HIV who also are PPD positive should receive prophylactic therapy—treatment to prevent the onset of active TB. Most patients are treated for 9 months with a medicine called isoniazid (INH), which is effective against active TB in patients who are HIV-positive, as well as those who are HIV-negative. Like antiretrovirals, INH must be taken every day for 9 months so that the TB bacteria do not become resistant to the drug. INH can cause liver problems, especially in African American and Latina women, a factor that is considered before prescribing the drug.

Active TB is characterized by fever, sweats, fatigue, cough, and bloody phlegm. Patients who have active TB are very contagious and must be isolated during early treatment to prevent the spread of infection.

Treatment for active TB involves 3 or 4 antibiotic medications taken for 6 to 12 months. Like antiretroviral therapy, the medication must be taken every day. If the drugs are not taken correctly, the tuberculosis bacteria can develop resistance, which is a huge global public health problem and one of the reasons so many people die from TB.

Because incorrect therapy can lead to resistance which, in turn, can lead to treatment failure and death, patients who have active TB should see a physician or other health care provider who has expert, up-to-date knowledge of TB and HIV treatment.