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Looking for TB and Cat related advice for HIV+ partner

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magnoman:
Thanks for the cat advice.

I am pretty sure we will be keeping him.  I originally got him to try and cheer my bf up about his diagnosis, so I was pretty upset that the doctor said we should get rid of the poor thing.

Sadly I am not sure that the HIV doctors here are brilliant, I suspect they are more overworked than anything and as far as I am aware there is just the one treatment center in this city.  As I say it is all regulated by the government so you get what you get!

I'm still a little worried about the TB medication they want him to take.  It seems to me that if he was vaccinated as a child they should at least be testing to see whether he is still immune rather than trying to get him to take three pills a day for the next year.  He already has to look forward to HIV Medication in the distant future.

leatherman:
here's some info about that med that was easy to find by googling up "Isoniazid package insert"

--- Quote ---Isoniazid Dosing Information

Usual Adult Dose for Tuberculosis -- Active:

Active infection: 5 mg/kg (up to 300 mg) IM or orally once a day, or 15 mg/kg (up to 900 mg) 2 to 3 times a week. Therapy is usually continued for 6 months, or 3 months beyond culture conversion (when given with rifampin and pyrazinamide).

Latent infection: 10-20 mg/kg/day orally once a day, not to exceed 300 mg/day

If isoniazid and pyrazinamide are used alone, isoniazid should be continued for 9 months. If the patient is HIV-positive, therapy should be continued for at least 9 months, or for 6 months beyond culture conversion. Longer duration of therapy should be considered for silico-, bone, and meningeal tuberculosis.

Usual Adult Dose for Tuberculosis -- Prophylaxis:

300 mg orally once a day or 900 mg orally 2 to 3 times a week. Isoniazid should be continued for 6 months to prevent the development of active tuberculosis in patients with no complicating factors. Patients with complicating factors such as HIV infection, diabetes, hematologic malignancy, or scars on chest X-ray should receive prophylaxis for 12 months.
--- End quote ---



--- Quote from: magnoman on November 28, 2012, 10:11:11 PM ---He already has to look forward to HIV Medication in the distant future.

--- End quote ---
please don't be so squeamish about taking some pills. Everybody takes meds, and as they get older most people take more and more. People with HIV aren't all that special. LOL

Besides, meds are NOT the enemy here. HIV and opportunistic infections are the enemies and could kill your boyfriend, while HIV meds and other prophylaxis will keep him healthy and able to live life to the fullest.  ;)

nixsmail:
I wanted to take a minute to respond to a subject that's near to my heart but not dear.

i have had/have TB as well as it's closest relative MAC. it turns out that i had inactive TB infection with an active MAC infection. when first discovered was on an extreme pill regimen now only have to take two, ethanbutol and azithromycin, but probably for the same length of time i'll have to take my HIV meds, the rest of my life. the pills keep the TB inactive or latent so that it never reactivates which for us poz people could be deadly at a faster pace than a neg person.

i would suspect that since your bf is negative for TB at this time the prophylaxis would only be good for the time that he's on the pills and i would guess for a short time after. one course of six months i'm pretty sure will not provide rest of life protection against TB. i copied some info that i'll paste below as well as the link so that you can check it out. just my two cents worth cause it might at least be something that you could keep up on. take care of each other and be well.

"The medicine usually taken for the treatment of latent TB infection is called isoniazid (INH). Taken for 6 to 9 months, INH kills the TB bacteria that are in the body. If you take your medicine as instructed by your doctor or nurse, it can keep you from developing active TB disease. Children, adolescents, and HIV-infected persons with latent TB infection need to take INH for 9 months.

Because there are less bacteria, treatment for latent TB infection is much easier than treatment for TB disease. Usually, only one drug is needed to treat latent TB infection. A person with active TB disease has a large amount of TB bacteria in the body. Several drugs are needed to treat active TB disease.

Sometimes people are given treatment for latent TB infection even if their skin test reaction is negative. This is often done with infants, children, and HIV-infected persons who have recently spent time with someone with active TB disease. This is because they are at very high risk of developing active TB disease soon after they become infected with TB bacteria.
It is important that you take all the pills as prescribed. If you start taking INH, you will need to see your doctor or nurse on a regular schedule. The doctor or nurse will check on how you are doing. Some people have serious side effects from INH. If you have any of the following side effects, call your doctor or nurse right away:

•no appetite
•nausea
•vomiting
•yellowish skin or eyes
•fever for 3 or more days
•abdominal pain
•tingling in the fingers and toes
 
Warning: Frequent or heavy drinking of alcoholic beverages (wine, beer, and liquor) while taking INH can be dangerous. Check with your doctor or nurse for more information.

People who have latent TB infection need to know the symptoms of active TB disease. If they develop symptoms of active TB disease, they should see a doctor right away."

http://www.cdc.gov/tb/publications/faqs/qa_latenttbinf.htm#Latent4

ps - wouldn't worry about the cat, have had many animals, have one cat and one dog currently and have never had any issues with taking care of them and i really don't know what i'd do without them. just use common sense and you should be fine.

magnoman:
Thank you so much for sharing your experience nixsmail.

I had read quite a bit about Isoniazid before posting here, I think I might even have read the article you kindly linked to as well.

What I missed was the fact that Isoniazid is sometimes prescribed for people who are negative for Latent TB, especially those in high risk groups like infants, children if they had been exposed

I researched quite a bit about TB medication this morning before posting this and had read quite a lot about Isoniazid.

Rather like you I would be surprised if a course of Isoniazid would provide lifetime protection against TB, having said that I am told that TB is highly prevalent here, although I would have thought less so in the cities than out in the country.  What I am still unsure of is how likely it is that he could catch TB from his hospital visits, and general time out and about.  My limited understanding of it is that you are unlikely to catch it out and about and that is generally caught from someone you are in close continual contact with.

If it isn't too much trouble or too painful it would be interesting to hear how you think you caught it.

Thanks also Leatherman for this hugely important point to remember: "Besides, meds are NOT the enemy here. HIV and opportunistic infections are the enemies and could kill your boyfriend, while HIV meds and other prophylaxis will keep him healthy and able to live life to the fullest."

It is of course completely true and I apologize if I came across as overly squeamish!

nixsmail:
no problem with the response, it's just that it's a pain in the ass having to take the extra pills for the rest of my life. but am taking the HIV meds anyway so as long as my body doesn't start doing anything strange i am going to be ok. that said my situation was as follows.

i work in a hospital but not in an area that is patient orientated. that is, my contact with patients is extremely limited and other than entering through the same door as the patients, i have little or nothing to do with them.

i'm in california and this part varies a little by state i think, but i would suppose that it's generally true. i'm required to test for TB every year because of working in the hospital (not anymore because once you have TB you will always test pos for it) and the test in Oct 2010 was administered and i really thought nothing of it but the next day had a raging itchy boil thing on my arm. went to the doc to have it checked and they immediately put me in a room where air only goes in not out. had to give sputum samples, get a blood check and wait for the docs. the docs told me to go straight home, no stopping no nothing and to stay there until the health department contacted me. they gave me my initial prescriptions (5) and was told to start taking them immediately.

the health dept showed up and interviewed me and we soon discovered that no one that i knew was sick or could possibly have given it to me. i was also required to stay at home under threat of arrest for not doing so, even if i wore a mask. the health dept said i could have simply been in contact with an individual at the grocery and if the droplets from their cough got into my system bingo.

the hospital also checked and they did not have any patients that they were aware of that could have given it either. so i really don't know who gave me the gift. but was off work from 10-7-10 to 2-14-11 and had to be cleared by the health dept and our employee heath and my doc before returning to work. they also started multiple people in my dept that i had close contact with but all tested neg.

turned out that the TB was inactive but the MAC was active and the treatment is almost identical. i lost 30 lbs from it and was starting to look like some of the first HIV victims almost like a walking skeleton. went from 168 to 134 almost in about 2 weeks.

so i would guess that being out and about, one would want to pay attention to someone who is coughing, which i would guess that most people dismiss almost immediately. i wouldn't get super paranoid about it and i would guess that as long as he's taking the drugs that would probably counteract the exposure. so sorry this got so long but it really was a pain and if only one person pays attention and possibly prevents themselves from acquiring it then it's worth it. hope all this helps. take care.

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