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Looking for TB and Cat related advice for HIV+ partner

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magnoman:
Thanks so much for the detailed reply.  Sounds like it almost certainly is a good idea for my bf to take the pills, despite currently being negative for TB.  Will just monitor for side effects.

I also found this article http://www.aidsmap.com/page/2456215/ which seemed to suggest that Isoniazid is effective and recommended for those already on Anti-Virals.

I'm yet to find much that recommends Isoniazid for those not yet on Anti-virals, but your experience and the fact that it is recommended by the doctors here does seem to me that it would make sense for my partner to take the medications.

Kitty K:
Hi Magnoman,

I can fill you in a bit about the TB, Im a nurse specialist in Australia for TB.

The INH treatment for 6-9 months is to treat a Latent Infection (you have the bug in your body but you dont have active disease). When you say your partner tested negative, how did they test him? If it was a tuberculin skin test and it came back negative, it is quite unusual that they would give him prophylaxis. If they did a sputum sample or a Chest Xray, they were just checking for active disease.

INH prophylaxis will not give life long protection to TB and if you are living in a high burden country, there is good chance he may be exposed again after treatment ends.

You are right, you generally need a fair amount of close contact to a person with active disease to become infected, doesnt mean to say you couldnt be really unlucky out in public or in a work/school environment. It depends on the infectivity of the affected person (there are various degrees of infectiousness).

The BCG vaccination (TB vaccine) given in childhood has a very broad efficacy range. Here is Australia all our policies state that the range is between 0-80% so there is good chance that it has done little and will continue to provide little protection for your partner.

INH can have some nasty side effects for some people and you will need to pay close attention to his Liver Function Tests while is on it. Probably best to limit alcohol intake whilst he is on it too.

If over the course of years he develops symptoms (night sweats, weightloss, a cough that lasts longer than 2 weeks and/or he is coughing up blood) he should revisit his TB doctor.

In regards to the cat.... just make sure he washes his hands after he handles the kitty litter and he will be fine!

Hope this helps  ;)

KK

magnoman:
Thanks so much Kitty.

Apparently all the TB tests, sputum, xray and skin all came back as negative.

Supposedly the World Health Organisation recommend INH.  In this report, http://www.who.int/tb/challenges/hiv/tbhiv_brochure_singles.pdf, they state:

"Prevent TB. People living with HIV who are routinely exposed
to TB should be protected against becoming ill with TB. Such
protection is cheap and simple—a daily dose of isoniazid. By
end 2015, 30% of people living with HIV who do not have
active TB should receive this preventive treatment."

I guess that the levels of TB where we are in Latin America is sufficiently high to suggest that we are routinely exposed to TB.  All this reading is getting me neurotic and perhaps I should start taking it too!

We will just monitor it and hope he gets no side effects.  They don't seem to do any Liver Function tests at the moment, just a HIV blood test every 3 months.

We will keep an eye out for Isoniazid side effects and hope he doesn't suffer from any.

Again appreciate the response.  With regard to the cat litter, that now seems to have become my job! :(

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