Prevention of tuberculosis in HIV infected patients
The concept of primary prophylaxis for tuberculous comes from the idea that if we allow the HIV inflected patients to develop active tuberculosis, then patients's immunity will be destroyed more rapidly. The increasing number of cases will burden restrained resources for treatment and will increase the transmission in population. Many studies have succeeded in preventing active tuberculosis in tuberculin test positive HIV infected patients by using INH prophylaxis. Current recommendation for INH prophylaxis is INH 300 milligram per day for 6-12 months in patients who has HIV seroposositive and tuberculin reaction equal to or greater than 5 millimeter. Active tuberculosis has to be excluded before starting INH prophylaxis. One problem of INH prophylaxis which is a great concern is compliance of patient to prophylaxis. The poor regularity will create more problem on INH drug resistant problem. So INH primary prophylaxis should be recommended for use only in patients whose compliance can be ensured.
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