Paper II
2025 March (Supplementary) (2010 Scheme)

Question

Rifabutin/ Rifampicin in Tuberculosis in AIDS patients.

Q140.3 marksShort Answers

Answer

Rifabutin is the appropriate choice in AIDS patients on antiretroviral therapy — it is a much weaker inducer of hepatic CYP3A4 than rifampicin, avoiding the severe drug interaction rifampicin would cause with protease inhibitors and non-nucleoside reverse transcriptase inhibitors (which rifampicin would render subtherapeutic through potent enzyme induction). Rifabutin retains comparable antitubercular efficacy to rifampicin while being compatible with most ART regimens, making it the preferred rifamycin in this specific clinical setting.

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