Lack of association between plasma levels of non-nucleoside reverse transcriptase inhibitors & virological outcomes during rifampicin co-administration in HIV-infected TB patients.

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dc.contributor.authorRamachandran, Geetha
dc.contributor.authorHemanth Kumar, A K
dc.contributor.authorPonnuraja, C
dc.contributor.authorRamesh, K
dc.contributor.authorRajesh, Lakshmi
dc.contributor.authorChandrasekharan, C
dc.contributor.authorSwaminathan, Soumya
dc.date.accessioned2015-01-14T04:34:07Z
dc.date.available2015-01-14T04:34:07Z
dc.date.issued2013-12
dc.description.abstractBackground & objectives: Among patients with HIV-associated tuberculosis (TB), reduced plasma non-nucleoside reverse transcriptase inhibitors (NNRTI) concentrations during rifampicin (RMP) co-administration could lead to HIV treatment failure. This study was undertaken to examine the association between plasma nevirapine (NVP) and efavirenz (EFV) concentrations and virological outcomes in patients infected with HIV-1 and TB. Methods: This was a nested study undertaken in a clinical trial of patients with HIV-1 and TB, randomized to two different once-daily antiretroviral treatment (ART) regimens along with anti-TB treatment (ATT). Trough concentrations of plasma NVP and EFV were estimated at months 1 (during ATT and ART) and 6 months (ART only) by HPLC. Plasma HIV-1 RNA level >400 copies/ml or death within 6 months of ART were considered as unfavourable outcomes. Genotyping of CYP2B6 516G>T polymorphism was performed. Results: Twenty nine per cent of patients in NVP arm had an unfavourable outcome at 6 months compared to 9 per cent in EFV arm (P<0.08). The mean NVP and EFV levels estimated at 1 and 6 months did not significantly differ between favourable and unfavourable responders. Logistic regression analysis showed CYP2B6 516G>T polymorphism significantly associated with virologic outcome in patients receiving EFV–based regimen. Interpretation & conclusions: Trough plasma concentrations of NVP and EFV did not show any association with response to ART in patients on ATT and once-daily ART. CYP2B6 516G>T polymorphism was associated with virologic outcome among patients on EFV.en_US
dc.identifier.citationRamachandran Geetha, Hemanth Kumar A K, Ponnuraja C, Ramesh K, Rajesh Lakshmi, Chandrasekharan C, Swaminathan Soumya. Lack of association between plasma levels of non-nucleoside reverse transcriptase inhibitors & virological outcomes during rifampicin co-administration in HIV-infected TB patients. Indian Journal of Medical Research. 2013 Dec; 138(6): 955-961.en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/155105
dc.language.isoenen_US
dc.source.urihttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3978988/en_US
dc.subjectHIV-1 & tuberculosisen_US
dc.subjectNNRTIsen_US
dc.subjectrifampicinen_US
dc.subjectTDMen_US
dc.subjectvirologic outcomeen_US
dc.titleLack of association between plasma levels of non-nucleoside reverse transcriptase inhibitors & virological outcomes during rifampicin co-administration in HIV-infected TB patients.en_US
dc.typeArticleen_US
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