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A Pharmacology Perspective on Simultaneous Tuberculosis and Hepatitis C Treatment

Russell R. Kempker, Wael A. Alghamdi, Mohammad H. Al-Shaer, Gena Burch, Charles A. Peloquin
Russell R. Kempker
aDivision of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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Wael A. Alghamdi
bDepartment of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
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Mohammad H. Al-Shaer
cDepartment of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, Florida, USA
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Gena Burch
cDepartment of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, Florida, USA
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Charles A. Peloquin
cDepartment of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, Florida, USA
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DOI: 10.1128/AAC.01215-19
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Tables

  • TABLE 1

    Elimination of antituberculosis drugs and their effects on enzyme and transporter activitya

    TABLE 1
    • ↵a —, either unknown or no well-established effect. ABC, ATP-binding cassette transporters; CYP, cytochrome 450; OATP, organic-anion-transporting polypeptide; BCRP, breast cancer resistance protein; MRP1, multidrug resistance-associated protein 1; P-gp, P-glycoprotein; PAS, p-aminosalicylic acid; SLC, solute carrier family; UGT, uridine 5′-diphospho-glucuronosyltransferase.

  • TABLE 2

    Elimination of DAAs for hepatitis C and their effects on enzymes and transporters activitya

    TABLE 2
    • ↵a —, either unknown or no well-established effect. BCRP, breast cancer resistance protein; CYP, cytochrome 450; DAAs, direct-acting antiviral; OATP, organic-anion-transporting polypeptide; P-gp, P-glycoprotein; UGT, uridine 5′-diphospho-glucuronosyltransferase.

  • TABLE 3

    Drug-drug interactions between drug-susceptible tuberculosis and hepatitis C drugsa

    TABLE 3
    • ↵a *, as recommended in the AALSD/IDSA hepatitis C treatment guidelines; #, drugs put into drug-susceptible and drug-resistant categories based on where they are commonly utilized (overlap does exist); INH, isoniazid; RIF, rifampin; RFP, rifapentine; RFB, rifabutin; PZA, pyrazinamide; ETH, ethambutol; red, drugs that should not be coadminstered; orange, potential clinically significant interaction; yellow, potential weak interaction unlikely to be clinically significant; green, no clinically significant interaction expected.

  • TABLE 4

    Drug-drug interactions between drug-resistant tuberculosis and hepatitis C drugsa

    TABLE 4
    • ↵a *, as recommended in the AALSD/IDSA hepatitis C treatment guidelines; #, drugs put into drug-susceptible and drug-resistant categories based on where they are commonly utilized (overlap does exist); LEVO, levofloxacin; MOXI, moxifloxacin; AMK, amikacin; KAN, kanamycin; CAP, capreomycin; LZD, linezolid; CFZ, clofazimine; PAS, para-aminosalicylic acid; CS, cycloserine; ETN, ethionamide; BDQ, bedaquiline; DEL, delamanid; orange, potential clinically significant interaction; yellow, potential weak interaction unlikely to be clinically significant; green, no clinically significant interaction expected. Genotypes for first-line treatment with elbasvir and grazoprevir, see reference 94.

  • TABLE 5

    Characteristics of anti-tuberculosis drugs related to liver disease

    TABLE 5
    • ↵a Although levofloxacin and moxifloxacin were associated with increased risk of acute liver injury compared to clarithromycin (100), they are generally not considered hepatotoxic drugs.

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A Pharmacology Perspective on Simultaneous Tuberculosis and Hepatitis C Treatment
Russell R. Kempker, Wael A. Alghamdi, Mohammad H. Al-Shaer, Gena Burch, Charles A. Peloquin
Antimicrobial Agents and Chemotherapy Nov 2019, 63 (12) e01215-19; DOI: 10.1128/AAC.01215-19

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A Pharmacology Perspective on Simultaneous Tuberculosis and Hepatitis C Treatment
Russell R. Kempker, Wael A. Alghamdi, Mohammad H. Al-Shaer, Gena Burch, Charles A. Peloquin
Antimicrobial Agents and Chemotherapy Nov 2019, 63 (12) e01215-19; DOI: 10.1128/AAC.01215-19
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  • Top
  • Article
    • ABSTRACT
    • INTRODUCTION
    • TB AND HCV DRUG METABOLISM
    • DDIs BETWEEN ANTI-TB AND HCV DRUGS
    • LIVER DISEASE AND SUBSTANCE USE DISORDER
    • CONCLUSION
    • ACKNOWLEDGMENTS
    • REFERENCES
  • Figures & Data
  • Info & Metrics
  • PDF

KEYWORDS

pharmacology
tuberculosis
hepatitis C
drug interactions
cotreatment

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