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.
