Open AccessParadoxically elevated efavirenz concentrations in HIV/tuberculosis-coinfected patients with CYP2B6 516TT genotype on rifampin-containing antituberculous therapy
Author(s) -
Awewura Kwara,
Margaret Lartey,
Kwamena W.C. Sagoe,
Michael H. Court
Publication year - 2011
Publication title -
aids
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.195
H-Index - 216
eISSN - 1473-5571
pISSN - 0269-9370
DOI - 10.1097/qad.0b013e3283427e05
Subject(s) - efavirenz , rifampicin , cyp2b6 , genotype , tuberculosis , medicine , sida , pharmacotherapy , virology , combination therapy , coinfection , pharmacology , immunology , human immunodeficiency virus (hiv) , antiretroviral therapy , viral disease , biology , viral load , cyp3a4 , gene , genetics , pathology , cytochrome p450 , metabolism
Some individuals have higher efavirenz plasma concentrations during rifampin-containing tuberculosis (TB) therapy, contrary to the expected induction effect of rifampin. Among HIV-infected patients without (n = 38) and with TB on rifampin-containing therapy (n = 18), we tested the hypothesis that drug-gene interaction may explain the highly variable drug interactions. Two-way analysis of variance revealed a significant interaction between CYP2B6 516G→T polymorphism and rifampin-containing therapy, suggesting that efavirenz dose adjustment may need to be individualized on the basis of the patient's genotype.