A Systematic Review on the Effect of HIV Infection on the Pharmacokinetics of First-Line Tuberculosis DrugsDaskapan, A., Idrus, L. R., Postma, M. J., Wilffert, B., Kosterink, J. G. W., Stienstra, Y., Touw, D. J., Andersen, A. B., Bekker, A., Denti, P., Hemanth Kumar, A. K., Jeremiah, K., Kwara, A., McIlleron, H., Meintjes, G., van Oosterhout, J. J., Ramachandran, G., Rockwood, N., Wilkinson, R. J., van der Werf, T. S. & Alffenaar, J-W. C., Jun-2019, In : Clinical Pharmacokinetics. 20 p.
Research output: Contribution to journal › Review article › Academic › peer-review
- PharmacoTherapy, Epidemiology and Economics
- Microbes in Health and Disease (MHD)
- Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET)
- Value, Affordability and Sustainability (VALUE)
- Guided Treatment in Optimal Selected Cancer Patients (GUTS)
- Biopharmaceuticals, Discovery, Design and Delivery (BDDD)
- Targeted Gynaecologic Oncology (TARGON)
- Pharmacokinetics, Toxicology and Targeting
- Groningen Research Institute for Asthma and COPD (GRIAC)
- Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE)
INTRODUCTION: Contrasting findings have been published regarding the effect of human immunodeficiency virus (HIV) on tuberculosis (TB) drug pharmacokinetics (PK).
OBJECTIVES: The aim of this systematic review was to investigate the effect of HIV infection on the PK of the first-line TB drugs (FLDs) rifampicin, isoniazid, pyrazinamide and ethambutol by assessing all published literature.
METHODS: Searches were performed in MEDLINE (through PubMed) and EMBASE to find original studies evaluating the effect of HIV infection on the PK of FLDs. The included studies were assessed for bias and clinical relevance. PK data were extracted to provide insight into the difference of FLD PK between HIV-positive and HIV-negative TB patients. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and its protocol was registered at PROSPERO (registration number CRD42017067250).
RESULTS: Overall, 27 studies were eligible for inclusion. The available studies provide a heterogeneous dataset from which consistent results could not be obtained. In both HIV-positive and HIV-negative TB groups, rifampicin (13 of 15) and ethambutol (4 of 8) peak concentration (Cmax) often did not achieve the minimum reference values. More than half of the studies (11 of 20) that included both HIV-positive and HIV-negative TB groups showed statistically significantly altered FLD area under the concentration-time curve and/or Cmax for at least one FLD.
CONCLUSIONS: HIV infection may be one of several factors that reduce FLD exposure. We could not make general recommendations with respect to the role of dosing. There is a need for consistent and homogeneous studies to be conducted.
|Number of pages||20|
|Publication status||Published - Jun-2019|