title: Use of non-nucleoside analogues together with rifampin in HIV patients with tuberculosis.
abstract: OBJECTIVE
  The concomitant use of rifampin (RFP) with efavirenz (EFV) or nevirapine (NVP) is frequent in HIV patients with tuberculosis (TB). The necessity of increasing the dose of EFV remains controversial. The aim of the study was to evaluate the outcome of HIV infection in patients treated with non-nucleoside reverse transcriptase inhibitor (NNRTI)-based antiretroviral therapy (ART) and RFR.
  
  
  METHODS
  Retrospective analysis of HIV patients who were simultaneously treated with RFP and NVP or EFV. The dose of EFV was considered to be adjusted in those patients receiving 600 mg when weighing <60 kg and 800 mg if >60 kg and was considered nonadjusted when the dose given was 600 mg in patients >60 kg.
  
  
  RESULTS
  63 patients were included: 13 received NVP and 50 received EFV-based ART (30 adjusted and 20 nonadjusted). Treatment failure was observed in 7 (53.8%) of the NVP group; 11 (55%) of the nonadjusted EFV group, and 8 (26.7%) of the adjusted EFV group (P = .04). The relative risk (RR) of treatment failure comparing nonadjusted and adjusted EFV was 3.36 (95% Cl, 1.02-11.11). The proportion of treatment failure was 9/18 (50%) in the nonadjusted and 5/27(18.5%) in the adjusted EFV group.
  
  
  CONCLUSIONS
  The effectiveness of NVP and nonadjusted EFV was lower than adjusted EFV-based ART. It may be advisable to increase the dose of EFV to 800 mg once daily when administered with rifampin in patients weighing >60 kg.
authors.affiliation: Department of Internal Medicine-Infectious Diseases, Hospital del Mar, Barcelona, Spain. judithvillar@yahoo.es
authors.forename: J
authors.initials: J
authors.lastname: Villar
authors.forename: P
authors.initials: P
authors.lastname: Sánchez
authors.forename: A
authors.initials: A
authors.lastname: González
authors.forename: L
authors.initials: L
authors.lastname: Sorli
authors.forename: M M
authors.initials: MM
authors.lastname: Montero
authors.forename: A
authors.initials: A
authors.lastname: Guelar
authors.forename: E
authors.initials: E
authors.lastname: Solé
authors.forename: J L
authors.initials: JL
authors.lastname: López
authors.forename: H
authors.initials: H
authors.lastname: Knobel
mesh_terms: D000480:Alkynes; D048588:Benzoxazines / Q000008:administration & dosage*; D001835:Body Weight; D003521:Cyclopropanes; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D019829:Nevirapine / Q000008:administration & dosage*; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage*; D012293:Rifampin / Q000008:administration & dosage*; D017211:Treatment Failure; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy*
chemical_list: D000480:Alkynes; D048588:Benzoxazines; D003521:Cyclopropanes; D018894:Reverse Transcriptase Inhibitors; D019829:Nevirapine; C098320:efavirenz; D012293:Rifampin