Tuberculosis Week

Research from S. Chideya and colleagues provide new insights into HIV/AIDS co-infection

Tuberculosis Week Library Library Home This article was published in Tuberculosis Week, which you can subscribe to online.

"Maximum serum concentrations (C-max) and areas under the serum concentration time curve were determined. Clinical status was monitored throughout treatment. Of the 225 participants, 36 (16%) experienced poor treatment outcome ( treatment failure or death); 155 (69%) were infected with human immunodeficiency virus (HIV). Compared with published standards, low isoniazid C-max occurred in 84 patients (37%), low rifampin C-max in 188 (84%), low ethambutol C-max in 87 (39%), and low pyrazinamide C-max in 11 (5%). Median rifampin and pyrazinamide levels differed significantly by HIV status and CD4 cell count category. Only pyrazinamide pharmacokinetics were significantly associated with treatment outcome; low pyrazinamide C-max was associated with a higher risk of documented poor treatment outcome, compared with normal C-max (50% vs. 16%; P< .01). HIV-infected patients with a CD4 cell count <200 cells/mu L had a higher risk of poor treatment outcome (27%) than did HIV-uninfected patients (11%) or HIV-infected patients with a CD4 cell count >= 200 cells/mu L (12%; P = .01). After adjustment for HIV infection and CD4 cell count, patients with low pyrazinamide C-max were 3 times more likely than patients with normal pyrazinamide C-max to have poor outcomes ( adjusted risk ratio, 3.38; 95% confidence interval, 1.84-6.22). Lower than expected antituberculosis drug C-max occurred frequently, and low pyrazinamide C-max was associated with poor treatment outcome," wrote S. Chideya and colleagues.

The researchers concluded: "Exploring the global prevalence and significance of these findings may suggest modifications in treatment regimens that could improve tuberculosis cure rates.."

Chideya and colleagues published their study in Clinical Infectious Diseases (Isoniazid, Rifampin, Ethambutol, and Pyrazinamide Pharmacokinetics and Treatment Outcomes among a Predominantly HIV-Infected Cohort of Adults with Tuberculosis from Botswana. Clinical Infectious Diseases, 2009;48(12):1685-1694).

For additional information, contact S. Chideya, 452 6th Avenue, Brooklyn, NY 11215, USA.

The publisher of the journal Clinical Infectious Diseases can be contacted at: University Chicago Press, 1427 E 60th St., Chicago, IL 60637-2954, USA.

Keywords: United States, Brooklyn, HIV/AIDS Co-Infection, AIDS, Acquired Immune Deficiency Syndrome, Acquired Immunodeficiency Syndrome, Cutaneous Tuberculosis, Drugs, Ethambutol Hydrochloride, HIV, Human Immunodeficiency Virus Bacterial Infection, Immunology, Isoniazid, Mycobacteria, Mycobacterium Tuberculosis, Pharmaceuticals, Pharmacokinetics, Pyrazinamide, Rifampin, Sexually Transmitted Disease, Therapies, Therapy, Treatment, Viral, Virology.

This article was prepared by Tuberculosis Week editors from staff and other reports. Copyright 2009, Tuberculosis Week via NewsRx.com.