Clinical Manual for Management of the HIV-Infected ... - myCME.com

6–72 | Clinical Manual for Management of the HIV-Infected Adult/2006
Although HIV-uninfected persons without risks for liver
disease do not require routine laboratory monitoring,
HIV/TB coinfected patients have a higher risk of drug
toxicity. Laboratory monitoring may be repeated after 1
month of treatment and every 3 months thereafter, unless
symptoms or laboratory abnormalities warrant more
frequent testing. Persons with symptoms and AST or
ALT elevations >3 times the upper limit of normal, and
asymptomatic persons with aminotransferase elevations
>5 times the upper limit of normal, should have therapy
interrupted and should be managed thereafter in consul-
Table 4. Adverse Events Associated with Common Antituberculous Medications
Drug Frequent
(>5 per 100 patients)
tation with an expert. Patients should be monitored for
isoniazid-induced peripheral neuropathy; this adverse effect
is rare if pyridoxine is administered with isoniazid, as
recommended (Table 2). Testing of visual acuity and redgreen
color discrimination is recommended at the start
of therapy with ethambutol. Persons taking standard
ethambutol doses who have normal baseline examinationss
should be asked monthly about visual disturbances.
Those taking higher ethambutol dosages or prolonged
ethambutol treatment (>2 months) should have periodic
eye examinations for acuity and color discrimination.
Common
(>1-5 per 100 patients)
Infrequent
(>1 per 1,000 patients and