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. 2022 Jan-Dec:21:23259582221111077.
doi: 10.1177/23259582221111077.

Effect of Rifabutin in Dolutegravir Dosing: A Case Series

Maria A Mendoza  1   2 , Mohammad H Alshaer  3 , Giovanni Roldan  1 , Jose Guillermo Castro  4 , David Ashkin  5 , Charles A Peloquin  5 , Catherine V Boulanger  2
Affiliations

Effect of Rifabutin in Dolutegravir Dosing: A Case Series

Maria A Mendoza et al. J Int Assoc Provid AIDS Care. 2022 Jan-Dec.

Abstract

Background: Tuberculosis (TB) is the leading cause of death in human immunodeficiency virus (HIV)-infected people worldwide. Currently there are no studies examining the use of Rifabutin (RBN) and Dolutegravir (DTG) in co-infected persons. This is a case series of 4 co-infected patients receiving both agents who underwent Pharmacokinetic (PK) analysis. Methods and Results: This is a retrospective chart review study of four patients diagnosed with both HIV and TB, receiving RBN and DTG and undergoing therapeutic drug monitoring. All 4 cases had lower than expected DTG concentrations at least once, including those on the current recommended dose of DTG with RBN, and even those receiving higher doses. Conclusions: Given the frequency of low DTG and RBN concentrations, therapeutic drug monitoring (TDM) for these drugs is advisable. Prospective clinical studies are needed to further determine the PK interactions between RBN and DTG, and virologic response to treatment.

Keywords: HIV; dolutegravir; rifabutin; tuberculosis.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Patients’ clinical course.
See this image and copyright information in PMC

References

    1. Guidelines for treatment of drug-susceptible tuberculosis and patient care, 2017 update. Geneva: World Health Organization, 2017.
    1. Nahid P, Dorman SE, Alipanah N, et al. Official American thoracic society/centers for disease control and prevention/infectious diseases society of America clinical practice guidelines: treatment of drug-susceptible Tuberculosis. Clin Infect Dis. 2016;63(7):e147–e195. - PMC - PubMed
    1. World Health Organization. WHO recommends dolutegravir as preferred HIV treatment option in all populations. Accessed July 30, 2020.
    1. Burman WJ, Gallicano K, Peloquin C. Comparative pharmacokinetics and pharmacodynamics of the rifamycin antibacterials. Clin Pharmacokinet. 2001;40(5):327–341. - PubMed
    1. Dooley KE, Sayre P, Borland J, et al. Safety, tolerability, and pharmacokinetics of the HIV integrase inhibitor dolutegravir given twice daily with rifampin or once daily with rifabutin: results of a phase 1 study among healthy subjects. J Acquir Immune Defic Syndr. 2013;62(1):21–27. - PubMed