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Reduced plasma concentrations of antituberculosis drugs in patients with HIV infection
J Sahai1, K Gallicano, L Swick
1University of Ottawa, Ottawa General Hospital, Ontario, Canada.
Background:
Reports suggest that antituberculosis drugs are malabsorbed in patients with advanced HIV disease.
Objective:
To evaluate the pharmacokinetics of antituberculosis agents in HIV-seropositive patients at different stages of disease.
Design:
Parallel study.
Setting:
Two hospital outpatient clinics.
Participants:
12 healthy volunteers, 12 patients with asymptomatic HIV disease, 12 patients with symptomatic HIV disease, and 12 patients with symptomatic HIV disease and diarrhea.
Measurements:
Drug plasma concentrations were measured over 24 hours on day 4 of concurrent therapy.
Intervention:
Oral isoniazid (300 mg/d), rifampin (600 mg/d), pyrazinamide (1000 mg/d), and ethambutol (1000 mg/d).
Results:
Reduced total drug exposure to rifampin and pyrazinamide was associated with D-xylose malabsorption in persons with HIV infection or AIDS. Peak drug exposure to isoniazid was lower in patients with diarrhea.
Conclusions:
Reduced total drug exposure may be related to malabsorption in persons with HIV infection or AIDS.
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