Reduced plasma concentrations of antituberculosis drugs in patients with HIV infection.
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.
Sahai
J
J
University of Ottawa, Ottawa General Hospital, Ontario, Canada.
Gallicano
K
K
Swick
L
L
Tailor
S
S
Garber
G
G
Seguin
I
I
Oliveras
L
L
Walker
S
S
Rachlis
A
A
Cameron
D W
DW
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
D000995:Antitubercular Agents; D011718:Pyrazinamide; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin