title: Factors associated with reduced antituberculous serum drug concentrations in patients with HIV-TB coinfection.
abstract: We describe correlates of reduced antituberculous serum drug concentrations (SDCs) in HIV-infected patients receiving treatment for active tuberculosis (TB). Cross-sectional analysis of individuals diagnosed with HIV and active TB in Northern Alberta, Canada, was performed. Of the 30 HIV-TB cases, 27 underwent measurement of SDCs. Rates of low SDCs were 9 of 26 (34%) for isoniazid (INH) and 16 of 25 (64%) for rifamycins. Increased weight and elevated body mass index (BMI) correlated with low SDCs for rifampin (P < .05) and increased weight also correlated with reduced SDCs for INH (P < .05). This suggests that conventional antituberculous dosing may be too low and consideration should be given to increase the maximum initial weight-based doses in HIV-infected patients.
authors.affiliation: 1Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Rabia
authors.initials: R
authors.lastname: Ahmed
authors.forename: Ryan
authors.initials: R
authors.lastname: Cooper
authors.forename: Michelle
authors.initials: M
authors.lastname: Foisy
authors.forename: Evelina
authors.initials: E
authors.lastname: Der
authors.forename: Dennis
authors.initials: D
authors.lastname: Kunimoto
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000097:blood* / Q000493:pharmacokinetics / Q000627:therapeutic use; D015992:Body Mass Index; D001835:Body Weight; D060085:Coinfection / Q000097:blood* / Q000188:drug therapy; D003430:Cross-Sectional Studies; D016903:Drug Monitoring; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007538:Isoniazid / Q000097:blood* / Q000493:pharmacokinetics / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017828:Rifabutin / Q000097:blood* / Q000493:pharmacokinetics / Q000627:therapeutic use; D012293:Rifampin / Q000097:blood* / Q000493:pharmacokinetics / Q000627:therapeutic use; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents; D017828:Rifabutin; D007538:Isoniazid; D012293:Rifampin