Infection and Drug Resistance (Jul 2023)

Pharmacokinetics of Efavirenz 600mg in Combination with Rifampicin in Chinese HIV/TB Co-Infection Patients

  • Wang T,
  • Liu Y,
  • Zhu C,
  • Yang S,
  • Yang D,
  • Xiao J,
  • Gao G

Journal volume & issue
Vol. Volume 16
pp. 4659 – 4666

Abstract

Read online

Tongtong Wang,1,* Yingchu Liu,2,* Chunyu Zhu,1,* Siyuan Yang,3 Di Yang,4 Jiang Xiao,4 Guiju Gao4 1Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2School of General Practice and Continuing Education, Capital Medical University, Beijing, People’s Republic of China; 3Laboratory of Infectious Diseases Center, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China; 4Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guiju Gao, Professor of Medicine Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, No. 8, Jingshun Dongjie, Chaoyang District, Beijing, 100015, People’s Republic of China, Email [email protected]: Rifampicin is a known inducer of the cytochrome P450 (CYP2B6) enzyme, which can lead to a decrease in the concentration of efavirenz. Therefore, we conducted a study to evaluate the effect of daily rifampicin intake on efavirenz 600mg pharmacokinetics and HIV-1 virological suppression.Methods: Patients receiving antiretroviral therapy containing efavirenz (600mg daily), and we collected efavirenz concentration at four visit points: ART day 14 (PK1), ART day 42 (PK2), ART day 140 (PK3), and ART day 336 (PK4), and performed pharmacokinetics analysis.Results: From February 2017 to November 2020, 29 HIV/TB co-infection patients were included. Ninety percent of patients had a concentration of ≥ 1000ng/mL of efavirenz during the study. All patients had efavirenz Cmax ≥ 1000ng/mL, 86% patients showed good virology response.Conclusion: Our study shows that the use of rifampicin in HIV/TB co-infection patients does not affect efavirenz drug concentrations, that virological suppression is good and that no efavirenz dose adjustment is required.Keywords: HIV/TB, rifampicin, efavirenz, pharmacokinetics

Keywords