Q: I am a 41 years old male. I have enlarged lymph nodes in the chest region and have been diagnosed with lymph node TB. I have been having symptoms of mild fever, back pain and fatigue but no cough. I have been taking medicines (AKurit-4) for last one month and there is some improvement. I have been told by doctors that this TB is not contagious. Is this right? Can my wife get infected with TB if we sleep together and have sex? Another thing I would like to know is that what is the way in which the medicines need to be taken. I have been asked to take medicines on an empty stomach. What should be the time gap between taking medicines and meals? Doe this apply to drinks (tea/coffee) also? Can these be taken just before/after the medicines. Please tell.

A:Your doctor is correct in telling you that your TB is not contagious. There is no risk to your wife, especially after a month of treatment. All anti-tuberculosis drugs have to be taken in single daily doses (and not in divided doses as is often practiced), to achieve peak levels in blood. The greater the ratio between peak blood levels and the minimum inhibitory concentration (MIC) of the drug, the greater is the drugs activity against the bacteria. Rifampicin must be given on an empty stomach followed by meals 1-2 hours after drug intake, and this also includes drinks like tea / coffee. Nearly half the patients are at risk of having sub-optimal concentration if rifampicin is taken with food. Antacids containing aluminium and magnesium also reduce the absorption of rifampicin, so must be avoided. The efficacy of ATT is reduced by taking the drugs in divided doses, taking rifampicin after meals, and taking antacids, thereby affecting the outcome of treatment.