Journal Article

Drug-Drug Interactions in Inmates Treated for Human Immunodeficiency Virus and <i>Mycobacterium tuberculosis</i> Infection or Disease: An Institutional Tuberculosis Outbreak

P. Spradling, D. Drociuk, S. McLaughlin, L. M. Lee, C. A. Peloquin, K. Gallicano, C. Pozsik, I. Onorato, K. G. Castro and R. Ridzon

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 35, issue 9, pages 1106-1112
Published in print November 2002 | ISSN: 1058-4838
Published online November 2002 | e-ISSN: 1537-6591 | DOI: https://dx.doi.org/10.1086/343047
Drug-Drug Interactions in Inmates Treated for Human Immunodeficiency Virus and Mycobacterium tuberculosis Infection or Disease: An Institutional Tuberculosis Outbreak

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The use of rifamycins is limited by drug interactions in human immunodeficiency virus (HIV)–infected persons who are receiving highly active antiretroviral therapy (HAART). During a tuberculosis (TB) outbreak at a prison housing HIV-infected inmates, rifabutin was used to treat 238 men (13 case patients and 225 contacts). Steady-state peak plasma rifabutin concentrations were obtained after rifabutin dosages were adjusted for men receiving single-interacting HAART (with either 1 protease inhibitor [PI] or efavirenz), multi-interacting HAART (with either 2 PIs or ⩾1 PI with efavirenz), and for noninteracting HAART (>1 nucleoside reverse-transcriptase inhibitor or no HAART) without rifabutin dose adjustments. Low rifabutin concentrations occurred in 9% of those receiving noninteracting HAART, compared with 19% of those receiving single-interacting and 29% of those receiving multi-interacting HAART (χ2, 3.76; P = .05). Of 225 contacts treated with rifabutin-pyrazinamide, 158 (70%) completed treatment while incarcerated. Rifabutin-pyrazinamide therapy was difficult to implement, because of the need for dosage adjustments and expert clinical management.

Journal Article.  4188 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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