A patient with HIV who takes protease inhibitors develops tuberculosis and will begin treatment. Which drug regimen will be used for this patient?
a. Isoniazid, pyrazinamide, ethambutol + rifabutin
b. Isoniazid, pyrazinamide, ethambutol
c. Isoniazid, rifampin, pyrazinamide, ethambutol
d. Isoniazid + rifabutin
ANS: A
Patients with HIV who take protease inhibitors are susceptible to drug interactions with rifampin, which accelerates the metabolism of protease inhibitors. Rifabutin can be substituted for rifampin in patients with HIV, because the degree of acceleration of this metabolism is less. A three-drug regimen would increase drug resistance, as would a two-drug regimen.
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