title: Reduced plasma concentrations of antituberculosis drugs in patients with HIV infection.
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.
  
  
  METHODS
  Parallel study.
  
  
  METHODS
  Two hospital outpatient clinics.
  
  
  METHODS
  12 healthy volunteers, 12 patients with asymptomatic HIV disease, 12 patients with symptomatic HIV disease, and 12 patients with symptomatic HIV disease and diarrhea.
  
  
  METHODS
  Drug plasma concentrations were measured over 24 hours on day 4 of concurrent therapy.
  
  
  METHODS
  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.
authors.affiliation: University of Ottawa, Ottawa General Hospital, Ontario, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Sahai
authors.forename: K
authors.initials: K
authors.lastname: Gallicano
authors.forename: L
authors.initials: L
authors.lastname: Swick
authors.forename: S
authors.initials: S
authors.lastname: Tailor
authors.forename: G
authors.initials: G
authors.lastname: Garber
authors.forename: I
authors.initials: I
authors.lastname: Seguin
authors.forename: L
authors.initials: L
authors.lastname: Oliveras
authors.forename: S
authors.initials: S
authors.lastname: Walker
authors.forename: A
authors.initials: A
authors.lastname: Rachlis
authors.forename: D W
authors.initials: DW
authors.lastname: Cameron
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000493:pharmacokinetics*; D016022:Case-Control Studies; D003967:Diarrhea / Q000097:blood / Q000382:microbiology; D004977:Ethambutol / Q000493:pharmacokinetics; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000503:physiopathology; D006679:HIV Seropositivity / Q000097:blood; D006801:Humans; D007408:Intestinal Absorption; D007538:Isoniazid / Q000493:pharmacokinetics; D008297:Male; D008875:Middle Aged; D011718:Pyrazinamide / Q000493:pharmacokinetics; D012293:Rifampin / Q000493:pharmacokinetics
chemical_list: D000995:Antitubercular Agents; D011718:Pyrazinamide; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin