Table 2.

Summary of Mtb treatment factors that can exacerbate HIV infections.

Mtb Treatment	Effect on HIV Treatment
Drug–drug interactions	Rifamycin induces liver enzyme CYP3A which increases metabolism of antiretrovirals, notably nelfinavir. Increased CYP3A activity also results in increased toxic metabolites that cause hepatotoxicity and reduce CD4+ counts [124,125,126,127,128,129,130].
IRIS with the initiation of ART	The initiation of ART increases the likelihood of developing IRIS which increases the rate of non-compliance to the anti-TB and ART regimens [131,133,134,135,136].
Treatment adherence	Individually, non-adherence to HIV or TB treatment regimens are common. Treatment for dually infected patients is associated with a higher rate of non-adherence due to side effects, pill burden, and complex drug interactions [145,146,147,148,149,150,151,152].