{"id":3350,"date":"2006-05-12T10:37:52","date_gmt":"2006-05-12T09:37:52","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=3350"},"modified":"2013-12-06T18:28:17","modified_gmt":"2013-12-06T18:28:17","slug":"dosing-rifabutin-and-lopinavirr-sub-optimal-rifabutin-levels-reported-in-five-patients-dosed-according-to-current-guidelines","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/3350","title":{"rendered":"Dosing rifabutin and lopinavir\/r \u0096 sub-optimal rifabutin levels reported in five patients dosed according to current guidelines"},"content":{"rendered":"<p><strong>Simon Collins, HIV i-Base<\/strong><\/p>\n<p><strong>Hasanin Khachi and colleagues from Barts and the London Trust reported drug levels of rifabutin in five patients concurrently using lopinavir\/r-based ARV regimens. Following current guidelines (BHIVA, CDC), rifabutin dose was reduced from 300mg daily to 150mg three times a week, in five patients, and levels were measured using standard therapeutic drug monitoring after two weeks.<\/strong><\/p>\n<p>Rifabutin levels for all five patients were sub-therapeutic, (see Table 1) with one patient deteriorating clinically.<\/p>\n<p>The researchers concluded that this data suggests current BHIVA and CDC guidelines result in sub-therapeutic rifabutin levels and that further formal investigations are required to establish the clinical significance of this, and determine the optimum dosing regimes for Kaletra and rifabutin in co-infected patients.<\/p>\n<p><strong>Table 1: Rifabutin levels at week 2 <\/strong><\/p>\n<table border=\"0\">\n<tbody>\n<tr>\n<th>Patient<\/th>\n<th>Rifabution 4h post-level (mg\/L)<\/th>\n<th>Kaletra trough level (ng\/mL)<\/th>\n<\/tr>\n<tr>\n<td>1<\/td>\n<td>0.16<\/td>\n<td>9352*<\/td>\n<\/tr>\n<tr>\n<td>2<\/td>\n<td>0.33<\/td>\n<td>1030*<\/td>\n<\/tr>\n<tr>\n<td>3<\/td>\n<td>0.17<\/td>\n<td>18 035*<\/td>\n<\/tr>\n<tr>\n<td>4<\/td>\n<td>&lt;0.10<\/td>\n<td>1549*<\/td>\n<\/tr>\n<tr>\n<td>5<\/td>\n<td>0.16<\/td>\n<td>7910*<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Rifabutin post-dose: 0.50-\u00ad1.0 mg\/L<\/p>\n<p>Kaletra trough level: for wild type virus: 1000 ng\/L<\/p>\n<p>*Experienced patients: 8000 ng\/L<\/p>\n<p class=\"ref\">Reference:<\/p>\n<p class=\"ref\">Khachi H, Ladenheim D, Orkin C et al. Pharmacokinetic interactions between rifabutin and lopinavir\/ritonavir in HIV-infected patients with mycobacterial co-infection. Oral abstract O12.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Simon Collins, HIV i-Base Hasanin Khachi and colleagues from Barts and the London Trust reported drug levels of rifabutin in five patients concurrently using lopinavir\/r-based ARV regimens. Following current guidelines (BHIVA, CDC), rifabutin dose was reduced from 300mg daily to &hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,34,37],"tags":[49],"class_list":["post-3350","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-pk-and-drug-interactions","category-tb-coinfection","tag-bhiva-12th-2006"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/3350","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\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=3350"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/3350\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=3350"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=3350"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=3350"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}