title: Paradoxically elevated efavirenz concentrations in HIV/tuberculosis-coinfected patients with CYP2B6 516TT genotype on rifampin-containing antituberculous therapy.
abstract: Some individuals have higher efavirenz plasma concentrations during rifampin-containing tuberculosis (TB) therapy, contrary to the expected induction effect of rifampin. Among HIV-infected patients without (n = 38) and with TB on rifampin-containing therapy (n = 18), we tested the hypothesis that drug-gene interaction may explain the highly variable drug interactions. Two-way analysis of variance revealed a significant interaction between CYP2B6 516G→T polymorphism and rifampin-containing therapy, suggesting that efavirenz dose adjustment may need to be individualized on the basis of the patient's genotype.
authors.affiliation: The Miriam Hospital, Providence, Rhode Island 02906, USA. akwara@lifespan.org
authors.forename: Awewura
authors.initials: A
authors.lastname: Kwara
authors.forename: Margaret
authors.initials: M
authors.lastname: Lartey
authors.forename: Kwamena W
authors.initials: KW
authors.lastname: Sagoe
authors.forename: Michael H
authors.initials: MH
authors.lastname: Court
mesh_terms: D019380:Anti-HIV Agents / Q000494:pharmacology*; D000904:Antibiotics, Antitubercular / Q000494:pharmacology*; D015658:HIV Infections / Q000188:drug therapy* / Q000235:genetics; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D020641:Polymorphism, Single Nucleotide; D012293:Rifampin / Q000494:pharmacology*; D014376:Tuberculosis / Q000188:drug therapy* / Q000235:genetics
chemical_list: D019380:Anti-HIV Agents; D000904:Antibiotics, Antitubercular; D012293:Rifampin