A Systematic Review on the Effect of HIV Infection on the Pharmacokinetics of First-Line Tuberculosis Drugs

Alper Daskapan; Lusiana R Idrus; Maarten J Postma; Bob Wilffert; Jos G W Kosterink; Ymkje Stienstra; Daniel J Touw; Aase B Andersen; Adrie Bekker; Paolo Denti; Agibothu K Hemanth Kumar; Kidola Jeremiah; Awewura Kwara; Helen McIlleron; Graeme Meintjes; Joep J van Oosterhout; Geetha Ramachandran; Neesha Rockwood; Robert J Wilkinson; Tjip S van der Werf; Jan-Willem C Alffenaar

doi:10.1007/s40262-018-0716-8

A Systematic Review on the Effect of HIV Infection on the Pharmacokinetics of First-Line Tuberculosis Drugs

Alper Daskapan, Lusiana R Idrus, Maarten J Postma, Bob Wilffert, Jos G W Kosterink, Ymkje Stienstra, Daniel J Touw, Aase B Andersen, Adrie Bekker, Paolo Denti, Agibothu K Hemanth Kumar, Kidola Jeremiah, Awewura Kwara, Helen McIlleron, Graeme Meintjes, Joep J van Oosterhout, Geetha Ramachandran, Neesha Rockwood, Robert J Wilkinson, Tjip S van der WerfJan-Willem C Alffenaar

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Abstract

INTRODUCTION: Contrasting findings have been published regarding the effect of human immunodeficiency virus (HIV) on tuberculosis (TB) drug pharmacokinetics (PK).

OBJECTIVES: The aim of this systematic review was to investigate the effect of HIV infection on the PK of the first-line TB drugs (FLDs) rifampicin, isoniazid, pyrazinamide and ethambutol by assessing all published literature.

METHODS: Searches were performed in MEDLINE (through PubMed) and EMBASE to find original studies evaluating the effect of HIV infection on the PK of FLDs. The included studies were assessed for bias and clinical relevance. PK data were extracted to provide insight into the difference of FLD PK between HIV-positive and HIV-negative TB patients. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and its protocol was registered at PROSPERO (registration number CRD42017067250).

RESULTS: Overall, 27 studies were eligible for inclusion. The available studies provide a heterogeneous dataset from which consistent results could not be obtained. In both HIV-positive and HIV-negative TB groups, rifampicin (13 of 15) and ethambutol (4 of 8) peak concentration (Cmax) often did not achieve the minimum reference values. More than half of the studies (11 of 20) that included both HIV-positive and HIV-negative TB groups showed statistically significantly altered FLD area under the concentration-time curve and/or Cmax for at least one FLD.

CONCLUSIONS: HIV infection may be one of several factors that reduce FLD exposure. We could not make general recommendations with respect to the role of dosing. There is a need for consistent and homogeneous studies to be conducted.

Original language	English
Number of pages	20
Journal	Clinical Pharmacokinetics
DOIs	https://doi.org/10.1007/s40262-018-0716-8
Publication status	Published - Jun-2019

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Daskapan, A., Idrus, L. R., Postma, M. J., Wilffert, B., Kosterink, J. G. W., Stienstra, Y., Touw, D. J., Andersen, A. B., Bekker, A., Denti, P., Hemanth Kumar, A. K., Jeremiah, K., Kwara, A., McIlleron, H., Meintjes, G., van Oosterhout, J. J., Ramachandran, G., Rockwood, N., Wilkinson, R. J., ... Alffenaar, J.-W. C. (2019). A Systematic Review on the Effect of HIV Infection on the Pharmacokinetics of First-Line Tuberculosis Drugs. Clinical Pharmacokinetics. https://doi.org/10.1007/s40262-018-0716-8

@article{2e234cf5f8d141c08ca5e95d09b09d13,

title = "A Systematic Review on the Effect of HIV Infection on the Pharmacokinetics of First-Line Tuberculosis Drugs",

abstract = "INTRODUCTION: Contrasting findings have been published regarding the effect of human immunodeficiency virus (HIV) on tuberculosis (TB) drug pharmacokinetics (PK).OBJECTIVES: The aim of this systematic review was to investigate the effect of HIV infection on the PK of the first-line TB drugs (FLDs) rifampicin, isoniazid, pyrazinamide and ethambutol by assessing all published literature.METHODS: Searches were performed in MEDLINE (through PubMed) and EMBASE to find original studies evaluating the effect of HIV infection on the PK of FLDs. The included studies were assessed for bias and clinical relevance. PK data were extracted to provide insight into the difference of FLD PK between HIV-positive and HIV-negative TB patients. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and its protocol was registered at PROSPERO (registration number CRD42017067250).RESULTS: Overall, 27 studies were eligible for inclusion. The available studies provide a heterogeneous dataset from which consistent results could not be obtained. In both HIV-positive and HIV-negative TB groups, rifampicin (13 of 15) and ethambutol (4 of 8) peak concentration (Cmax) often did not achieve the minimum reference values. More than half of the studies (11 of 20) that included both HIV-positive and HIV-negative TB groups showed statistically significantly altered FLD area under the concentration-time curve and/or Cmax for at least one FLD.CONCLUSIONS: HIV infection may be one of several factors that reduce FLD exposure. We could not make general recommendations with respect to the role of dosing. There is a need for consistent and homogeneous studies to be conducted.",

author = "Alper Daskapan and Idrus, {Lusiana R} and Postma, {Maarten J} and Bob Wilffert and Kosterink, {Jos G W} and Ymkje Stienstra and Touw, {Daniel J} and Andersen, {Aase B} and Adrie Bekker and Paolo Denti and {Hemanth Kumar}, {Agibothu K} and Kidola Jeremiah and Awewura Kwara and Helen McIlleron and Graeme Meintjes and {van Oosterhout}, {Joep J} and Geetha Ramachandran and Neesha Rockwood and Wilkinson, {Robert J} and {van der Werf}, {Tjip S} and Alffenaar, {Jan-Willem C}",

year = "2019",

month = jun,

doi = "10.1007/s40262-018-0716-8",

language = "English",

journal = "Clinical Pharmacokinetics",

issn = "0312-5963",

publisher = "Springer International Publishing AG",

}

Daskapan, A, Idrus, LR, Postma, MJ, Wilffert, B, Kosterink, JGW , Stienstra, Y , Touw, DJ, Andersen, AB, Bekker, A, Denti, P, Hemanth Kumar, AK, Jeremiah, K, Kwara, A, McIlleron, H, Meintjes, G, van Oosterhout, JJ, Ramachandran, G, Rockwood, N, Wilkinson, RJ, van der Werf, TS & Alffenaar, J-WC 2019, 'A Systematic Review on the Effect of HIV Infection on the Pharmacokinetics of First-Line Tuberculosis Drugs', Clinical Pharmacokinetics. https://doi.org/10.1007/s40262-018-0716-8

TY - JOUR

T1 - A Systematic Review on the Effect of HIV Infection on the Pharmacokinetics of First-Line Tuberculosis Drugs

AU - Daskapan, Alper

AU - Idrus, Lusiana R

AU - Postma, Maarten J

AU - Wilffert, Bob

AU - Kosterink, Jos G W

AU - Stienstra, Ymkje

AU - Touw, Daniel J

AU - Andersen, Aase B

AU - Bekker, Adrie

AU - Denti, Paolo

AU - Hemanth Kumar, Agibothu K

AU - Jeremiah, Kidola

AU - Kwara, Awewura

AU - McIlleron, Helen

AU - Meintjes, Graeme

AU - van Oosterhout, Joep J

AU - Ramachandran, Geetha

AU - Rockwood, Neesha

AU - Wilkinson, Robert J

AU - van der Werf, Tjip S

AU - Alffenaar, Jan-Willem C

PY - 2019/6

Y1 - 2019/6

N2 - INTRODUCTION: Contrasting findings have been published regarding the effect of human immunodeficiency virus (HIV) on tuberculosis (TB) drug pharmacokinetics (PK).OBJECTIVES: The aim of this systematic review was to investigate the effect of HIV infection on the PK of the first-line TB drugs (FLDs) rifampicin, isoniazid, pyrazinamide and ethambutol by assessing all published literature.METHODS: Searches were performed in MEDLINE (through PubMed) and EMBASE to find original studies evaluating the effect of HIV infection on the PK of FLDs. The included studies were assessed for bias and clinical relevance. PK data were extracted to provide insight into the difference of FLD PK between HIV-positive and HIV-negative TB patients. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and its protocol was registered at PROSPERO (registration number CRD42017067250).RESULTS: Overall, 27 studies were eligible for inclusion. The available studies provide a heterogeneous dataset from which consistent results could not be obtained. In both HIV-positive and HIV-negative TB groups, rifampicin (13 of 15) and ethambutol (4 of 8) peak concentration (Cmax) often did not achieve the minimum reference values. More than half of the studies (11 of 20) that included both HIV-positive and HIV-negative TB groups showed statistically significantly altered FLD area under the concentration-time curve and/or Cmax for at least one FLD.CONCLUSIONS: HIV infection may be one of several factors that reduce FLD exposure. We could not make general recommendations with respect to the role of dosing. There is a need for consistent and homogeneous studies to be conducted.

AB - INTRODUCTION: Contrasting findings have been published regarding the effect of human immunodeficiency virus (HIV) on tuberculosis (TB) drug pharmacokinetics (PK).OBJECTIVES: The aim of this systematic review was to investigate the effect of HIV infection on the PK of the first-line TB drugs (FLDs) rifampicin, isoniazid, pyrazinamide and ethambutol by assessing all published literature.METHODS: Searches were performed in MEDLINE (through PubMed) and EMBASE to find original studies evaluating the effect of HIV infection on the PK of FLDs. The included studies were assessed for bias and clinical relevance. PK data were extracted to provide insight into the difference of FLD PK between HIV-positive and HIV-negative TB patients. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and its protocol was registered at PROSPERO (registration number CRD42017067250).RESULTS: Overall, 27 studies were eligible for inclusion. The available studies provide a heterogeneous dataset from which consistent results could not be obtained. In both HIV-positive and HIV-negative TB groups, rifampicin (13 of 15) and ethambutol (4 of 8) peak concentration (Cmax) often did not achieve the minimum reference values. More than half of the studies (11 of 20) that included both HIV-positive and HIV-negative TB groups showed statistically significantly altered FLD area under the concentration-time curve and/or Cmax for at least one FLD.CONCLUSIONS: HIV infection may be one of several factors that reduce FLD exposure. We could not make general recommendations with respect to the role of dosing. There is a need for consistent and homogeneous studies to be conducted.

U2 - 10.1007/s40262-018-0716-8

DO - 10.1007/s40262-018-0716-8

M3 - Review article

C2 - 30406475

SN - 0312-5963

JO - Clinical Pharmacokinetics

JF - Clinical Pharmacokinetics

ER -

A Systematic Review on the Effect of HIV Infection on the Pharmacokinetics of First-Line Tuberculosis Drugs

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