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Decreased Bioavailability of Rifampin and Other Antituberculosis Drugs in Patients with Advanced Human Immunodeficiency Virus Disease

Prema Gurumurthy,^1, Geetha Ramachandran,¹ A. K. Hemanth Kumar,¹ S. Rajasekaran,² C. Padmapriyadarsini,¹ Soumya Swaminathan,^1* S. Bhagavathy,¹ P. Venkatesan,¹ L. Sekar,¹ A. Mahilmaran,² N. Ravichandran,² and P. Paramesh²

Tuberculosis Research Centre (Indian Council of Medical Research), Chetput,¹ Government Hospital for Thoracic Medicine, Tambaram, Chennai, India²

Received 30 April 2004/ Returned for modification 2 July 2004/ Accepted 1 August 2004

We evaluated the effects of human immunodeficiency virus (HIV) disease on pharmacokinetics of antituberculosis medications by measuring concentrations of isoniazid and rifampin in blood and of pyrazinamide and ethambutol in urine. Peak concentration and exposure were reduced for rifampin, and rapid acetylators of isoniazid had lower drug levels. HIV and HIV-tuberculosis patients who have diarrhea and cryptosporidial infection exhibit decreased bioavailability of antituberculosis drugs.

Present address: K.J. Hospital Post Graduate & Research Foundation, Chennai, India.

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