Efavirenz Plasma Concentrations and HIV Viral Load in HIV/AIDS-tuberculosis Infection Patients Treated with Rifampicin
ABSTRACT: to determine the
effect of a rifampicin-containing tuberculosis regimen on efavirenz plasma
concentrations and viral load in HIV/AIDS-Tuberculosis infection patients who
received efavirenz-based antiretroviral therapy. Methods: plasma efavirenz
concentrations and HIV viral load were measured in HIV/AIDS patients treated
with 600 mg efavirenz-based antiretroviral for 3 to 6 months and in
HIV/AIDS-Tuberculosis infection patients treated with similar antiretroviral
regimen plus rifampicin-containing antituberculosis in Sulianti Saroso
Infectious disease Hospital, Jakarta. Plasma efavirenz concentration in both
groups were compared using Mann-Whitney test, while proportion of patients with
viral load >40 copy/mL were analyzed with chi-square test. Results: forty
fve patients (27 with HIV/AIDS and 18 with HIV/AIDS-Tuberculosis infections)
were recruited during the period of February to May 2015. The median efavirenz
plasma concentration obtained from HIV/AIDS group was 0,680 mg/L(range 0,24 to
5,67 mg/L and that obtained from HIV/AIDS-Tuberculosis group was 0.685 mg/L
(0.12 -2.23 mg/L) which was not signifcantly different statistically. The
proportion of patients with viral load ≥40 copies/mL after 3-6 months of ARV
treatment in the HIV/AIDS group was 51.9%, and in the HIV/AIDS-Tuberculosis
group was 72.2%, which was not signifcantly different statistically (Chi Square
test, p=0.291). Conclusion: plasma efavirenz concentration in
HIV/AIDS-tuberculosis patients receiving antiretroviral and rifampicin is not
signifcantly different from that on HIV/AIDS patients without tuberculosis.
Proportion of patients with viral load of >40 copy/mL is higher in HIV/AIDS-tuberculosis
patients receiving rifampicin compared to HIV/AIDS patients that not receive
rifampicin. However, this difference did not reach statistical signifcance.
Confrmatory studies with bigger sample size are needed to clarify the influence
of rifampicin on plasma level of efavirenzand and on viral load.
Author: Nina Mariana,
Purwantyastuti, Instiaty, Adria Rusli
Journal Code: jpkedokterangg160007