A Pilot Study of Immune Activation and Rifampin Absorption in HIV-Infected Patients without Tuberculosis Infection: A Short Report. (21st December 2017)

• Record Type: Journal Article
• Authors: Vinnard, Christopher; Manley, Isabel; Scott, Brittney; Bernui, Mariana; Adams, Joella; Varghese, Sheryl; Zentner, Isaac; Kutzler, Michele A.
• Other Names: Perlman David C. Academic Editor.
• Is Part Of: Tuberculosis research and treatment. Volume 2017(2017)
• Publication Date: 2017-12-21
• Subjects: Tuberculosis -- Periodicals; Tuberculosis -- Prevention -- Periodicals; Tuberculosis -- Treatment -- Periodicals; Tuberculosis -- Social aspects -- Periodicals; 616.995005
• DOI: 10.1155/2017/2140974
• Languages: English
• ISSNs: 2090-150X

Abstract

Abstract : Background . Rifampin malabsorption is frequently observed in tuberculosis patients coinfected with human immunodeficiency virus (HIV) but cannot be predicted by patient factors such as CD4+ T cell count or HIV viral load. Methods . We sought to describe the relationship between HIV-associated immune activation, measures of gut absorptive capacity and permeability, and rifampin pharmacokinetic parameters in a pilot study of 6 HIV-infected, tuberculosis-uninfected patients who were naïve to antiretroviral therapy. Results . The median rifampin area under the concentration-versus-time curve during the 8-hour observation period was 42.8 mg·hr/L (range: 21.2 to 57.6), with a median peak concentration of 10.1 mg/L (range: 5.3 to 12.5). We observed delayed rifampin absorption, with a time to maximum concentration greater than 2 hours, in 2 of 6 participants. There was a trend towards increased plasma concentrations of sCD14, a marker of monocyte activation in response to bacterial translocation, among participants with delayed rifampin absorption compared to participants with rapid absorption (p = 0.06 ). Conclusions . Delayed rifampin absorption may be associated with elevated markers of bacterial translocation among HIV-infected individuals naïve to antiretroviral therapy. This trial is registered withNCT01845298 .