Patient selection: HIV-infected patient with tuberculosis receiving antituberculous therapy
Reasons for failure to respond related to the mycobacteria:
(1) error in the diagnosis of tuberculosis
(2) mycobacterial strain resistant to antituberculous therapy
Reasons for failure to respond related to other conditions:
(1) bronchiectasis secondary to the tuberculosis
(2) heart failure or other comorbid condition
(3) superimposed pneumonia
(4) development of a tumor
Reasons for failure to respond related to the HIV disease:
(1) immune reconstitution syndrome (if recently started on antiretroviral therapy)
(2) progression of HIV disease
Reasons for failure to respond related to the drug therapy:
(1) poor adherence to the drug regimen
(2) poor drug absorption if oral drug regimen
Other factors to consider:
(1) poor drug potency (inactivated, dilute, counterfeit, etc)
