Document Detail

Reversible reduction of nevirapine plasma concentrations during rifampicin treatment in patients coinfected with HIV-1 and tuberculosis.
MedLine Citation:
PMID:  19731452     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Nevirapine (NVP) plasma levels are reduced in patients receiving rifampicin (RFM) for tuberculosis (TB) treatment. We determined variations over time of the pharmacokinetic parameters of NVP in patients who receive RFM. METHODS: HIV-1-infected patients with CD4+ T-lymphocyte count <or=100 cells per microliter and TB diagnosis received standard anti-TB therapy and a fixed-dose combination of stavudine, lamivudine, and NVP. Full NVP pharmacokinetic curves were calculated at 4 (T1) and 10 weeks (T2) of combined therapy and at 4 (T3) and 26 weeks after termination of anti-TB therapy. RESULTS: In 16 enrolled subjects, the median value of the area under the curve of NVP was reduced by 25.6% at T1 compared with NVP alone (43.7 vs. 58.7 microg x mL(-1) x h(-1); P = 0.02). The reduction was only 7.5% at T2 (54.3 vs. 58.7 microg x mL(-1) x h(-1); P = 0.17). The median C trough was reduced of 19.5% at T1 compared with T3 (3.3 vs. 4.2 microg/mL; P = 0.02) and of 7.1% at T2 compared with T3 (3.9 vs. 4.2 microg/mL; P = 0.17). The proportion of subjects with C trough values <or=3 microg/mL was 31.2% (5 of 16), 40.0% (6 of 15), and 7.7% (1 of 13) at T1, T2, and T3, respectively. CONCLUSIONS: The reduction of the area under the curve of NVP during concomitant RFM treatment substantially decreases over time.
Alberto Matteelli; Nuccia Saleri; Paola Villani; Victor Bonkoungou; Anna Cristina C Carvalho; Seni Kouanda; Marie J Sanou; Jacques Simporé; Laura Monno; Giampiero Carosi; Mario Regazzi; Mathurin Dembele
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  52     ISSN:  1525-4135     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-03     Completed Date:  2009-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  64-9     Citation Subset:  IM; X    
Institute of Infectious and Tropical Diseases, University of Brescia, Brescia, Italy.
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MeSH Terms
Anti-HIV Agents / blood*,  pharmacokinetics,  therapeutic use
Antibiotics, Antitubercular / administration & dosage*
CD4 Lymphocyte Count
Follow-Up Studies
HIV Infections / blood,  complications,  drug therapy*
Lamivudine / blood,  pharmacokinetics,  therapeutic use
Longitudinal Studies
Middle Aged
Nevirapine / blood*,  pharmacokinetics,  therapeutic use
Prospective Studies
Rifampin / administration & dosage*
Stavudine / blood,  pharmacokinetics,  therapeutic use
Tuberculosis / complications,  drug therapy*
Reg. No./Substance:
0/Anti-HIV Agents; 0/Antibiotics, Antitubercular; 129618-40-2/Nevirapine; 13292-46-1/Rifampin; 134678-17-4/Lamivudine; 3056-17-5/Stavudine

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