An Unexpected Interaction Between Dolutegravir and Latent TB Treatment

Once weekly isoniazid plus rifapentine for 3 months (3HP) is an effective treatment option for latent tuberculosis (TB) infection. Because of concerns regarding drug interactions, investigators conducted a pharmacokinetic study to assess whether 3HP can be safely administered with dolutegravir. Four HIV-uninfected healthy volunteers received dolutegravir daily for 19 days; on day 5, once-weekly isoniazid and rifapentine was added.

The study was terminated when two of the participants developed flu-like symptoms, fever, lymphopenia, and elevated transaminases soon after receiving the third dose of isoniazid and rifapentine. (One participant was hospitalized for orthostatic hypotension and received intravenous fluids.) The participants with cl…