Effect of isoniazid and rifapentine anti-tuberculosis on the pharmacokinetics of efavirenz in people living with HIV
10.16718/j.1009-7708.2025.02.007
- VernacularTitle:异烟肼联合利福喷丁预防性抗结核治疗对人类免疫缺陷病毒感染患者依非韦伦药代动力学影响的研究
- Author:
Zhangyufan HE
1
;
Qiaoling RUAN
;
Xinping YANG
;
Linmei PU
;
Lingyun SHAO
;
Wenhong ZHANG
;
Yungui ZHANG
;
Qingluan YANG
Author Information
1. 复旦大学附属华山医院感染科,上海 200040
- Publication Type:Journal Article
- Keywords:
efavirenz;
rifapentine;
plasma drug concentration;
human immunodeficiency virus
- From:
Chinese Journal of Infection and Chemotherapy
2025;25(2):162-167
- CountryChina
- Language:Chinese
-
Abstract:
Objective This study aimed to evaluate the interaction between antiretroviral drug efavirenz and anti-tuberculosis 1H3P3(isoniazid plus rifapentine)in people living with HIV.Methods HIV-positive individuals on efavirenz-containing(600 mg)antiretroviral therapy(ART)received 1H3P3 regimen containing rifapentine(450 mg)plus isoniazid(400 mg)3 times a week for 1 month.Efavirenz concentrations were measured at weeks 0,2,4,8.Rifapentine concentration was determined at weeks 2 and 4.HIV RNA load was determined at weeks 0 and 8.Treatment target was efavirenz concentration＞1 mg/L.The anti-TB prevention was considered acceptable if the target of efavirenz concentration was achieved in more than 80％of participants.The participants were followed up for 18 months to evaluate the efficacy of treatment.Results Thirty-one participants living with HIV were enrolled in the study.Two participants were excluded from PK analysis because his/her baseline efavirenz concentration＜1 mg/L,suggesting poor treatment adherence.Evaluable PK data were available for 29 participants,including 23(79.3％)males.The median[interquartile range(IQR)]age of the participants was 43.0(32.5,53.5)years.The median(IQR)efavirenz plasma concentration was 2.33(1.96,2.34)mg/L at week 0,2.32(1.90,3.28)mg/L at week 2,2.07(1.83,3.09)mg/L at week 4,and 2.71(2.14,3.33)mg/L at week 8.Efavirenz concentration did not show significant difference between the 4 time points(P＞0.05).Median(IQR)rifapentine concentration was 9.36(6.23,16.47)mg/L at week 2,and 9.36(6.41,15.56)mg/L at week 4.Rifapentine concentration did not show significant difference between week 2 and week 4(P＞0.05).Efavirenz concentrations was＞1 mg/L in all participants at weeks 2,4,and 8.Furthermore,efavirenz concentration was significantly higher in females and patients with body weight＜60 kg compared with males and those with body weight ≥60 kg(P＜0.05).None of the participants had symptoms or signs of active tuberculosis during 18-month follow-up.Conclusions Isoniazid plus rifapentine(1H3P3 regimen)did not have significant effect on the plasma concentrations of efavirenz.
