Reduced Plasma Concentrations of Antituberculosis Drugs in Patients With HIV Infection

Ann Intern Med. 1997 Aug 15;127(4):289-93. doi: 10.7326/0003-4819-127-4-199708150-00006.

Abstract

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.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antitubercular Agents / pharmacokinetics*
  • Case-Control Studies
  • Diarrhea / blood
  • Diarrhea / microbiology
  • Ethambutol / pharmacokinetics
  • Female
  • HIV Infections / blood*
  • HIV Infections / physiopathology
  • HIV Seropositivity / blood
  • Humans
  • Intestinal Absorption
  • Isoniazid / pharmacokinetics
  • Male
  • Middle Aged
  • Pyrazinamide / pharmacokinetics
  • Rifampin / pharmacokinetics

Substances

  • Antitubercular Agents
  • Pyrazinamide
  • Ethambutol
  • Isoniazid
  • Rifampin