Rifampin-Resistant TB During Boosted PI Therapy in HIV Patients

In New York City, three HIV patients with tuberculosis developed rifampin resistance after being switched to boosted PI therapy and alternate-day rifabutin.

Rifamycin is the guideline-recommended therapy for tuberculosis (TB) in HIV-positive adults (JW AIDS Clin Care Feb 25 2008). The preferred combination treatment is efavirenz-based antiretroviral therapy (ART) plus rifampin-based TB therapy. For patients who cannot take efavirenz, PI-based ART plus rifabutin-based TB therapy is recommended because of known interactions between rifampin and PIs. If a boosted PI is given, the standard rifabutin dose is supposed to be lowered (to 150 mg every other day), but data on TB treatment outcomes with this lower dose are scant. Given the risk for rifampin-resistant TB among HIV patients, understanding the clinical and resistance implications of treating TB with a lowered rifabutin dose is important.

Now,…

Reviewing Author

Carlos del Rio, MD

Disclosures

Grant/Research SupportNIH/National Institute of Allergy and Infectious Diseases; NIH/National Institute on Drug Abuse

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes; Vaccines

Leadership Positions in Professional SocietiesInternational Antiviral Society–USA (Board of Directors); Infectious Diseases Society of America (Past President)

Carlos del Rio, MD

Disclosures

Grant/Research SupportNIH/National Institute of Allergy and Infectious Diseases; NIH/National Institute on Drug Abuse

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes; Vaccines

Leadership Positions in Professional SocietiesInternational Antiviral Society–USA (Board of Directors); Infectious Diseases Society of America (Past President)

Rifampin-Resistant TB During Boosted PI Therapy in HIV Patients

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Reviewing Author