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Title: Nevirapine plasma concentrations and concomitant use of rifampin in patients coinfected with HIV-1 and tuberculosis
Authors: Reshma S. Autar
Ferdinand W.N.M. Wit
Jongkol Sankote
Apicha Mahanontharit
Thanomsak Anekthananon
Piroon Mootsikapun
Khanjtta Sujaikaew
David A. Cooper
Joep M.A. Lange
Praphan Phanuphak
Kiat Ruxrungtham
David M. Burger
The HIV Netherlands Australia Thailand Research Collaboration
University of Amsterdam
Mahidol University
Khon Kaen University
Kirby Institute
University of New South Wales (UNSW) Australia
PharmAccess Foundation
Chulalongkorn University
Radboud University Nijmegen Medical Centre
Keywords: Medicine;Pharmacology, Toxicology and Pharmaceutics
Issue Date: 1-Dec-2005
Citation: Antiviral Therapy. Vol.10, No.8 (2005), 937-943
Abstract: Objectives: In countries with high numbers of HIV/tuberculosis coinfection nevirapine and rifampin are used extensively. However, limited data are available about whether or not nevirapine and rifampin can be safely co-administered without the plasma concentration of nevirapine falling below therapeutic levels. Methods: Blood samples for determination of nevirapine plasma concentrations were collected from patients using nevirapine 200 mg twice daily with or without concomitant rifampin. Bivariate and multivariate linear regression models were used to investigate factors possibly related to nevirapine concentrations. Results: We received 74 blood samples from patients using nevirapine plus rifampin, and collected blood samples from an equal number of controls using nevirapine only. Groups were similar for age, gender, weight, height and body mass index (BMI). In the rifampin group the mean nevirapine concentration was 5.47 ± 2.66mg/l, whereas in the control group the mean nevirapine concentration was 8.72 ± 3.98 mg/l. In the rifampin group seven nevirapine trough concentrations were low (<3.1 mg/l), while in the control group two patients had low nevirapine trough concentrations (P=0.164). In the multivariate linear regression analysis, corrected for time after drug intake, the use of rifampin was significantly (P<0.001) associated with lower nevirapine plasma concentrations, whereas higher BMI reached borderline significance (P=0.065). Conclusion: Although nevirapine plasma concentrations were 3.3 mg/l lower when co-administered with rifampin, still more than 86% of these patients had nevirapine plasma concentrations >3.1 mg/l. Our results suggest that from a pharmacological point of view the majority of Thai coinfected patients, who have low BMIs, reach nevirapine plasma concentrations that are adequate for treatment of HIV. However this can only be undertaken if nevirapine plasma concentration monitoring is available and can be closely followed. © 2005 International Medical Press.
ISSN: 13596535
Appears in Collections:Scopus 2001-2005

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