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Anti-tuberculosis drug concentrations and treatment outcomes in patients with both tuberculosis and HIV infection

Shadi Baniasadi, Payam Tabarsi, Seyed Alireza Nadji, Farzad Kobarfard, Raha Eskandari, Fanak Fahimi
European Respiratory Journal 2013 42: P2829; DOI:
Shadi Baniasadi
1Pharmaceutical Care Department, National Research Institute of Tuberculosis and Lung Disease, Tehran, Islamic Republic of Iran
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Payam Tabarsi
1Pharmaceutical Care Department, National Research Institute of Tuberculosis and Lung Disease, Tehran, Islamic Republic of Iran
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Seyed Alireza Nadji
1Pharmaceutical Care Department, National Research Institute of Tuberculosis and Lung Disease, Tehran, Islamic Republic of Iran
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Farzad Kobarfard
1Pharmaceutical Care Department, National Research Institute of Tuberculosis and Lung Disease, Tehran, Islamic Republic of Iran
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Raha Eskandari
1Pharmaceutical Care Department, National Research Institute of Tuberculosis and Lung Disease, Tehran, Islamic Republic of Iran
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Fanak Fahimi
1Pharmaceutical Care Department, National Research Institute of Tuberculosis and Lung Disease, Tehran, Islamic Republic of Iran
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Abstract

Introduction: A poor treatment response in persons with tuberculosis (TB) and HIV infection can be related to low anti-TB drug concentrations, particularly if diarrhea and malabsorption are present. Although therapeutic drug monitoring (TDM) is not routinely recommended, growing bodies of literature suggest that TDM may be a useful tool to optimize therapy.

Aims: We objected in this study to determine serum concentrations of anti-TB drugs and treatment outcomes in HIV/TB patients.

Methods: Using HPLC method, serum concentrations of izoniazid (INH), rifampin (RIF), and pyrazinamide (PZA) were determined 3-5 days after receiving medications and treatment outcomes of the patients were evaluated.

Results: Twenty two patients [median age: 35 years (rang 27-57 years), median CD4+ count: 16 cells/mm3 (range 5-444 cells/mm3)] were enrolled in the study. All patients had low or very low serum concentrations of INH and RIF, 2 h after drugs ingestion. Serum concentrations of PZA were in normal and low ranges in 5 (22.73%) and 17 (77.27%) of the patients respectively. Of 22 patients, 9 (41%) were considered cured. Five patients (22.7%) died during treatment (four of them had low or very low serum concentrations of three medications), three were lost to follow-up, three were still receiving therapy, and two had relapsed (one of them was infected with Mycobacterium Kansasii).

Conclusions: Low and very low serum concentrations of INH, RIF, and PZA and poor treatment outcomes are common among our patient. Future study in a wider patient sample over a longer follow-up period are required to explore the association of between anti-TB drug concentrations and treatment outcomes.

  • Pharmacology
  • Infections
  • Treatments
  • © 2013 ERS
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Anti-tuberculosis drug concentrations and treatment outcomes in patients with both tuberculosis and HIV infection
Shadi Baniasadi, Payam Tabarsi, Seyed Alireza Nadji, Farzad Kobarfard, Raha Eskandari, Fanak Fahimi
European Respiratory Journal Sep 2013, 42 (Suppl 57) P2829;

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Anti-tuberculosis drug concentrations and treatment outcomes in patients with both tuberculosis and HIV infection
Shadi Baniasadi, Payam Tabarsi, Seyed Alireza Nadji, Farzad Kobarfard, Raha Eskandari, Fanak Fahimi
European Respiratory Journal Sep 2013, 42 (Suppl 57) P2829;
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