{"id":15527,"date":"2011-08-01T01:11:23","date_gmt":"2011-08-01T01:11:23","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=15527"},"modified":"2011-08-01T01:11:23","modified_gmt":"2011-08-01T01:11:23","slug":"pharmacokinetics-of-different-rifabutin-dosing-strategies-with-lopinavirritonavir-based-art","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/15527","title":{"rendered":"Pharmacokinetics of different rifabutin dosing strategies with lopinavir\/ritonavir-based ART"},"content":{"rendered":"

Polly Clayden, HIV i-Base<\/strong><\/p>\n

Interactions between rifampicin and protease inhibitors makes treating patients coinfected with HIV and TB more complicated.<\/p>\n

Rifabutin is an alternative rifamycin, which can be used in patients receiving a protease inhibitor. Recent findings suggest that the current recommended dose of lopinavir\/r (LPV\/r) is suboptimal. There are limited data regarding the newer formulation of LPV\/r.<\/p>\n

Investigators from University of Cape Town, International Union Against Tuberculosis and Lung Disease and WHO evaluated the pharmacokinetics (PK) of rifabutin in co -infected patients on a first line TB regimen before and after the initiation of LPV\/r-based ART.<\/p>\n

Suhashni Naiker and colleagues showed findings from this study in a poster at CROI 2011.<\/p>\n

A group of 16 patients on stable rifabutin-containing TB regimens were initiated on LPV\/r-containing HAART. At HAART initiation they were randomised to receive either: rifabutin 150 mg daily for 1 month followed by 150 mg 3 times weekly, or 3 times weekly doses followed by daily doses.<\/p>\n

The investigators measured serial rifabutin and 25-O-desacetyl rifabutin concentrations during a dose interval after 4 weeks of rifabutin 300 mg daily, after 4 weeks of 150 mg rifabutin daily with LPV\/r-based HAART, and after 4 weeks of rifabutin 150 mg 3 times a week with LPV\/r-based ART.<\/p>\n

At baseline the participants were a mean (SD) of 31.6 (5.5) years, 59.0 (9.4) kg, 160.1 (7.1) cm and 147 (43) CD4 cells\/mm3. Ten were men. Two were not included in the analysis due to poor adherence.<\/p>\n

The investigators reported median AUC0-24 and Cmax, for participants receiving 300 mg rifabutin daily, 150 mg rifabutin three times a week, and 150 mg rifabutin daily, respectively, of 3026 ng\/mL.h and 297ng\/mL, 2307 ng\/mL.h and 168 ng\/mL, and 5010 ng\/mL.h and 311ng\/mL.<\/p>\n

They found that rifabutin was well tolerated at all dosing strategies. There was one case of uveitis that occurred before\u00a0 LPV\/r was initiated, and one grade 2 transaminitis and one grade 2 neutropenia were also reported.<\/p>\n

They concluded that rifabutin 150 mg daily used with LPV\/r produces Cmax <\/sub>concentrations within the recommended target range of 300 to 900 ng\/mL.<\/p>\n

Reference<\/p>\n

Naiker S et al. Pharmacokinetic evaluation of different rifabutin dosing strategies in African TB patients on lopinavir\/ritonavir-based ART. 18th CROI, 27 February\u00962 March 2011, Boston. Poster abstract 650<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Polly Clayden, HIV i-Base Interactions between rifampicin and protease inhibitors makes treating patients coinfected with HIV and TB more complicated. Rifabutin is an alternative rifamycin, which can be used in patients receiving a protease inhibitor. Recent findings suggest that the …<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,34,37],"tags":[65],"class_list":["post-15527","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-pk-and-drug-interactions","category-tb-coinfection","tag-croi-2011"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/15527","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=15527"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/15527\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=15527"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=15527"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=15527"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}