pharmacokinetics of anti tuberculosis drugs in hiv positive and hiv negative adults in malawi
Download
Skip this Video
Download Presentation
Pharmacokinetics of anti-tuberculosis drugs in HIV-positive and HIV-negative adults in Malawi

Loading in 2 Seconds...

play fullscreen
1 / 13

Pharmacokinetics of anti-tuberculosis drugs in HIV-positive and HIV-negative adults in Malawi - PowerPoint PPT Presentation


  • 109 Views
  • Uploaded on

Pharmacokinetics of anti-tuberculosis drugs in HIV-positive and HIV-negative adults in Malawi. J.J. van Oosterhout 1,2 , F. Dzinjalamala 3 , A. Dimba 4 , D. Waterhouse 5 , G. Davies 6,7 , M. Molyneux 5,6 , E. Molyneux 8 , S. Ward 7

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' Pharmacokinetics of anti-tuberculosis drugs in HIV-positive and HIV-negative adults in Malawi' - colin-guerrero


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
pharmacokinetics of anti tuberculosis drugs in hiv positive and hiv negative adults in malawi

Pharmacokinetics of anti-tuberculosis drugs in HIV-positive and HIV-negative adults in Malawi

J.J. van Oosterhout 1,2, F. Dzinjalamala3, A. Dimba 4, D. Waterhouse 5, G. Davies 6,7, M. Molyneux5,6, E. Molyneux8, S. Ward7

1College of Medicine, Department of Medicine, Blantyre, Malawi,

2Dignitas International, Zomba, Malawi,

3 College of Medicine, Department of Biochemistry, Blantyre, Malawi,

4National Tuberculosis Control Program, Lilongwe, Malawi,

5Liverpool School of Tropical Medicine, Liverpool, United Kingdom,

6Malawi-Liverpool-Wellcome Trust Clinical Research Programme Unit, Blantyre, Malawi,

7University of Liverpool, Liverpool, United Kingdom,

8College of Medicine, Department of Pediatrics, Blantyre, Malawi

slide2

Background

  • High HIV prevalence and high TB-HIV co-infection rate in Malawi
  • High prevalence of malnutrition
  • Few pharmacokinetic studies of TB drugs sub-Saharan Africa
  • Some data suggest HIV infection affects TB drug levels

Aims

  • Pharmacokinetic profiles of 4 drugs of Malawi first line TB treatment regimen (RHZE)
  • Impact of HIV status and other factors on TB drug pharmacokinetics
methods
Methods
  • Intensive PK study adult Malawians
  • Sputum AFB smear positive PTB
  • Intensive phase TB treatment
  • Exclusion: vomiting, diarrhea; Hb <8.0 g/dL; recent stop ART
  • FDC formulations; dosing according to recommended weight bands
  • Sampling: 0 – 0.5 – 1 – 2 – 3 – 4 – 6 – 8 – 24
  • R and Z: high-performance liquid chromatography
  • H and E: mass spectrometry
patient characteristics
Patient characteristics
  • N=47
  • 51% male
  • Mean age 34
  • 30 (65%) HIV+
    • Median CD4 = 167 (53% <200) cells/µL
    • 14 (47%) on ART
  • Median weight 54.5 kg
  • Median BMI 19.2 (46% <18.5)
slide5

Results compatible with other studies from the region

A. Tostmann et al; AAC 2013. B. McIlleron et al; AAC 2006. C. Saleri et al; JAC 2012

slide6

No significant impact on main PKparameters:

  • Dose, weight, weight-adjusted dose, gender, age
  • HIV infection, being on ART
potential causes of low rifampicin exposure
Potential causes of low rifampicin exposure
  • Dose–weight
  • Malnutrition
  • HIV infection
  • Severe illness
  • Sample collection/transport
  • Breakfast
  • Pharmaco-genetic factors
    • SLCO1B1 polymorphisms
  • Quality of drug formulation
slide8

Conclusions:

- PKresults comparable to SSA studies

low rifampicin exposure

- No impact of HIV infection

Acknowledgements: National TB Control Programme; University of Liverpool

slide11

8-24

3-5

20-50

2-6

ad