1

ISBN : 978-616-11-1839-6 2 ()

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ISBN 978-616-11-1839-6

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22

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30

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.. 2555

1.

1.1

1.2

1.3

1.4

1.5

1.6

1.7

1.8

1.9

1.10

1.11

1.12

1.13

1.14

1.15

1.16()

1.17

1.18

1.19

1.20

1.21

2.

2.1

2.2

2.3

2.4

2.5

2.6

.. 2555

2.7

2.8

2.9

2.10

2.11

2.12

2.13

2.14

2.15

2.16

2.17

2.18

2.19

2.20

3.

3.1

1)

2)

3.2

1)

2)

3)

4)

5)

6)

7)

8)

9)

10)

11)

12)

13)

AFB Acid-fastbacilli

AIDS Acquiredimmunodeficiencysyndrome

ALT Alaninetransaminase

ART Antiretroviraltherapy

AST Aspartatetransaminase

Cs D-cycloserine

CSF Cerebrospinalfluid

CXR ChestX-ray

DOT Directlyobservedtherapy

DST Drugsusceptibilitytesting

DRTB Drug-resistanttuberculosis

E,EMB Ethambutol

Eto Ethionamide

EPTB Extrapulmonarytuberculosis

FDC Fixed-dosecombination

FLDST First-linedrugsusceptibilitytesting

H,INH Isoniazid

HIV Humanimmunodeficiencyvirus

INF Interferon

IGRA Interferon-gammareleaseassay

Km Kanamycin

Lfx Levofloxacin

MDRTB Multidrug-resistanttuberculosis

MTB Mycobacteriumtuberculosis

NNRTIs Non-nucleosidereversetranscriptaseinhibitors

NRTIs Nucleosidereversetranscriptaseinhibitors

NTM Non-tuberculousmycobacterium

NTP Nationaltuberculosiscontrolprogramme

PAS Para-aminosalicylicacid

PCR Polymerasechainreaction

(Abbreviation)

PIs Proteaseinhibitors

PMN Polymorphonuclearcell

PTB Pulmonarytuberculosis

PTB+ Sputumsmearpositivepulmonarytuberculosis

PTBneg. Sputumsmearnegativepulmonarytuberculosis

RapidDST Rapiddrugsusceptibilitytesting

R,RMP Rifampicin

RT-PCR Real-timePCR

SLDST Second-linedrugsusceptibilitytesting

S,SM Streptomycin

SSC Standardshort-coursechemotherapy(2HRZE/4HR)

TAD Treatmentafterdefault

TAF Treatmentafterfailure

TB Tuberculosis

TB/HIV HIV-relatedTB

TST Tuberculinskintest

WHO Worldhealthorganization

XDRTB Extensivelydrug-resistanttuberculosis

Z,PZA Pyrazinamide

(strength of recommendation)

++ (strongly recommend)

(costeffective)

+ (recommend)

+/- (neither recommend nor against)

- (against)

- - (strongly against)

(quality of evidence)

I

(systematic review)

(randomize-controlledclinicaltrials)

(well-designed,randomize-controlled,clinicaltrial)1

II

(systematic review)

(non-randomized,controlled,clinicaltrials)

(well-designed,non-randomized,controlledclinicaltrial)

(Strength of Recommendation and Quality of Evidence)

(cohort)

(casecontrolanalyticstudies)

/

(multiple time series)

..2480

III

1)(descriptivestudies)

2)(fair-designed,

controlledclinicaltrial)

IV

1)

(consensus)

2)

2

V

(anecdotalreport)

.. 2555

.. 2555

(ABBREVIATION)

(STRENGTHOFRECOMMENDATIONANDQUALITYOFEVIDENCE)

1

1 3

2 5

2.1 5

2.1.1 5

2.1.2 5

2.1.3 6

2.1.4 tuberculinskintest,interferongammareleaseassays(IGRA) 7

2.2 10

2.2.1 10

2.2.2 10

2.2.3 13

2.2.4 18

(treatmentafterinterruption)

2.2.5 19

(organizationoftuberculosistreatmentunit,TBClinic)

3 23

3.1 23

3.2 26

4 (first-lineanti-tuberculosisdrugs;FLD) 29

4.1 29

4.2 30

4.3 31

4.4 35

5 37

5.1/ 37

5.2 40

5.3 40

5.4 41

43

1 44

1.1 44

1.2 47

2 48

3 rapid molecular testing 49

4 51

2556

1 ..2010-2012 1

..2011

2 12

3 13

4 16

(Re-treatmentregimenwithfirst-linedrugs)

5 23

6 24

7 25

8 26

(Standardshort-coursechemotherapy;SSC)

9corticosteroid 27

10 29

11 32

12 39

(Primaryprophylaxis)CD4

13 41

creatinineclearanceE

H

H

R

4.3.1

3

33

4

(++,III)

maculopapular rash

prednisolone

systemicsteroidprednisolone40-60

o HREZ

o 1/3 1/2

2-3

o

4.3.2 /

H,RZbilirubin

AST/ALTR

> 60

(++,III)

55.2

34

4

(++,III)

AST/ALTtotalbilirubin(TB)

AST/ALTTB1-21

(++,III)

AST/ALT 3

H,RZE,quinolone,streptomycin

AST/ALT < 3

3

(++,III)

TB > 3 ./ AST/ALT 3

R

AST/ALT 5

H,RZE,quinolonestreptomycin

AST/ALT < 5

1

re-challenge (++,II)

fulminant hepatitis

AST/ALT