Nutritional supplementation increases Rifampin exposure among tuberculosis patients coinfected with HIV

Kidola Jeremiah; Paolo Denti; Emmanuel Chigutsa; Daniel Faurholt-Jepsen; George PrayGod; Nyagosya Range; Sandra Castel; Lubbe Wiesner; Christian Munch Hagen; Michael Christiansen; John Changalucha; Helen McIlleron; Henrik Friis; Åse Bengård Andersen

doi:10.1128/AAC.02307-13

Nutritional supplementation increases Rifampin exposure among tuberculosis patients coinfected with HIV

Kidola Jeremiah, Paolo Denti, Emmanuel Chigutsa, Daniel Faurholt-Jepsen, George PrayGod, Nyagosya Range, Sandra Castel, Lubbe Wiesner, Christian Munch Hagen, Michael Christiansen, John Changalucha, Helen McIlleron, Henrik Friis, Åse Bengård Andersen

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37 Citationer (Scopus)

Abstract

Nutritional supplementation to tuberculosis (TB) patients has been associated with increased weight and reduced mortality, but its effect on the pharmacokinetics of first-line anti-TB drugs is unknown. A cohort of 100 TB patients (58 men; median age, 35 [interquartile range {IQR}, 29 to 40] years, and median body mass index [BMI], 18.8 [17.3 to 19.9] kg/m(2)) were randomized to receive nutritional supplementation during the intensive phase of TB treatment. Rifampin plasma concentrations were determined after 1 week and 2 months of treatment. The effects of nutritional supplementation, HIV, time on treatment, body weight, and SLCO1B1 rs4149032 genotype were examined using a population pharmacokinetic model. The model adjusted for body size via allometric scaling, accounted for clearance autoinduction, and detected an increase in bioavailability (+14%) for the patients in the continuation phase. HIV coinfection in patients not receiving the supplementation was found to decrease bioavailability by 21.8%, with a median maximum concentration of drug in serum (Cmax) and area under the concentration-time curve from 0 to 24 h (AUC0-24) of 5.6 μg/ml and 28.6 μg · h/ml, respectively. HIV-coinfected patients on nutritional supplementation achieved higher Cmax and AUC0-24 values of 6.4 μg/ml and 31.6 μg · h/ml, respectively, and only 13.3% bioavailability reduction. No effect of the SLCO1B1 rs4149032 genotype was observed. In conclusion, nutritional supplementation during the first 2 months of TB treatment reduces the decrease in rifampin exposure observed in HIV-coinfected patients but does not affect exposure in HIV-uninfected patients. If confirmed in other studies, the use of defined nutritional supplementation in HIV-coinfected TB patients should be considered in TB control programs. (This study has the controlled trial registration number ISRCTN 16552219.).

Originalsprog	Engelsk
Tidsskrift	Antimicrobial Agents and Chemotherapy
Vol/bind	58
Udgave nummer	6
Sider (fra-til)	3468-3474
Antal sider	7
ISSN	0066-4804
DOI	https://doi.org/10.1128/AAC.02307-13
Status	Udgivet - jun. 2014

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10.1128/AAC.02307-13

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Jeremiah, K., Denti, P., Chigutsa, E., Faurholt-Jepsen, D., PrayGod, G., Range, N., Castel, S., Wiesner, L., Hagen, C. M., Christiansen, M., Changalucha, J., McIlleron, H., Friis, H., & Andersen, Å. B. (2014). Nutritional supplementation increases Rifampin exposure among tuberculosis patients coinfected with HIV. Antimicrobial Agents and Chemotherapy, 58(6), 3468-3474. https://doi.org/10.1128/AAC.02307-13

Jeremiah, K, Denti, P, Chigutsa, E, Faurholt-Jepsen, D, PrayGod, G, Range, N, Castel, S, Wiesner, L, Hagen, CM, Christiansen, M, Changalucha, J, McIlleron, H, Friis, H & Andersen, ÅB 2014, 'Nutritional supplementation increases Rifampin exposure among tuberculosis patients coinfected with HIV', Antimicrobial Agents and Chemotherapy, bind 58, nr. 6, s. 3468-3474. https://doi.org/10.1128/AAC.02307-13

@article{314c41ebe356437aadff1e045eb2d297,

title = "Nutritional supplementation increases Rifampin exposure among tuberculosis patients coinfected with HIV",

abstract = "Nutritional supplementation to tuberculosis (TB) patients has been associated with increased weight and reduced mortality, but its effect on the pharmacokinetics of first-line anti-TB drugs is unknown. A cohort of 100 TB patients (58 men; median age, 35 [interquartile range {IQR}, 29 to 40] years, and median body mass index [BMI], 18.8 [17.3 to 19.9] kg/m(2)) were randomized to receive nutritional supplementation during the intensive phase of TB treatment. Rifampin plasma concentrations were determined after 1 week and 2 months of treatment. The effects of nutritional supplementation, HIV, time on treatment, body weight, and SLCO1B1 rs4149032 genotype were examined using a population pharmacokinetic model. The model adjusted for body size via allometric scaling, accounted for clearance autoinduction, and detected an increase in bioavailability (+14%) for the patients in the continuation phase. HIV coinfection in patients not receiving the supplementation was found to decrease bioavailability by 21.8%, with a median maximum concentration of drug in serum (Cmax) and area under the concentration-time curve from 0 to 24 h (AUC0-24) of 5.6 μg/ml and 28.6 μg · h/ml, respectively. HIV-coinfected patients on nutritional supplementation achieved higher Cmax and AUC0-24 values of 6.4 μg/ml and 31.6 μg · h/ml, respectively, and only 13.3% bioavailability reduction. No effect of the SLCO1B1 rs4149032 genotype was observed. In conclusion, nutritional supplementation during the first 2 months of TB treatment reduces the decrease in rifampin exposure observed in HIV-coinfected patients but does not affect exposure in HIV-uninfected patients. If confirmed in other studies, the use of defined nutritional supplementation in HIV-coinfected TB patients should be considered in TB control programs. (This study has the controlled trial registration number ISRCTN 16552219.).",

author = "Kidola Jeremiah and Paolo Denti and Emmanuel Chigutsa and Daniel Faurholt-Jepsen and George PrayGod and Nyagosya Range and Sandra Castel and Lubbe Wiesner and Hagen, {Christian Munch} and Michael Christiansen and John Changalucha and Helen McIlleron and Henrik Friis and Andersen, {{\AA}se Beng{\aa}rd}",

note = "CURIS 2014 NEXS 204",

year = "2014",

month = jun,

doi = "10.1128/AAC.02307-13",

language = "English",

volume = "58",

pages = "3468--3474",

journal = "Antimicrobial Agents and Chemotherapy",

issn = "0066-4804",

publisher = "American Society for Microbiology",

number = "6",

}

TY - JOUR

T1 - Nutritional supplementation increases Rifampin exposure among tuberculosis patients coinfected with HIV

AU - Jeremiah, Kidola

AU - Denti, Paolo

AU - Chigutsa, Emmanuel

AU - Faurholt-Jepsen, Daniel

AU - PrayGod, George

AU - Range, Nyagosya

AU - Castel, Sandra

AU - Wiesner, Lubbe

AU - Hagen, Christian Munch

AU - Christiansen, Michael

AU - Changalucha, John

AU - McIlleron, Helen

AU - Friis, Henrik

AU - Andersen, Åse Bengård

N1 - CURIS 2014 NEXS 204

PY - 2014/6

Y1 - 2014/6

N2 - Nutritional supplementation to tuberculosis (TB) patients has been associated with increased weight and reduced mortality, but its effect on the pharmacokinetics of first-line anti-TB drugs is unknown. A cohort of 100 TB patients (58 men; median age, 35 [interquartile range {IQR}, 29 to 40] years, and median body mass index [BMI], 18.8 [17.3 to 19.9] kg/m(2)) were randomized to receive nutritional supplementation during the intensive phase of TB treatment. Rifampin plasma concentrations were determined after 1 week and 2 months of treatment. The effects of nutritional supplementation, HIV, time on treatment, body weight, and SLCO1B1 rs4149032 genotype were examined using a population pharmacokinetic model. The model adjusted for body size via allometric scaling, accounted for clearance autoinduction, and detected an increase in bioavailability (+14%) for the patients in the continuation phase. HIV coinfection in patients not receiving the supplementation was found to decrease bioavailability by 21.8%, with a median maximum concentration of drug in serum (Cmax) and area under the concentration-time curve from 0 to 24 h (AUC0-24) of 5.6 μg/ml and 28.6 μg · h/ml, respectively. HIV-coinfected patients on nutritional supplementation achieved higher Cmax and AUC0-24 values of 6.4 μg/ml and 31.6 μg · h/ml, respectively, and only 13.3% bioavailability reduction. No effect of the SLCO1B1 rs4149032 genotype was observed. In conclusion, nutritional supplementation during the first 2 months of TB treatment reduces the decrease in rifampin exposure observed in HIV-coinfected patients but does not affect exposure in HIV-uninfected patients. If confirmed in other studies, the use of defined nutritional supplementation in HIV-coinfected TB patients should be considered in TB control programs. (This study has the controlled trial registration number ISRCTN 16552219.).

AB - Nutritional supplementation to tuberculosis (TB) patients has been associated with increased weight and reduced mortality, but its effect on the pharmacokinetics of first-line anti-TB drugs is unknown. A cohort of 100 TB patients (58 men; median age, 35 [interquartile range {IQR}, 29 to 40] years, and median body mass index [BMI], 18.8 [17.3 to 19.9] kg/m(2)) were randomized to receive nutritional supplementation during the intensive phase of TB treatment. Rifampin plasma concentrations were determined after 1 week and 2 months of treatment. The effects of nutritional supplementation, HIV, time on treatment, body weight, and SLCO1B1 rs4149032 genotype were examined using a population pharmacokinetic model. The model adjusted for body size via allometric scaling, accounted for clearance autoinduction, and detected an increase in bioavailability (+14%) for the patients in the continuation phase. HIV coinfection in patients not receiving the supplementation was found to decrease bioavailability by 21.8%, with a median maximum concentration of drug in serum (Cmax) and area under the concentration-time curve from 0 to 24 h (AUC0-24) of 5.6 μg/ml and 28.6 μg · h/ml, respectively. HIV-coinfected patients on nutritional supplementation achieved higher Cmax and AUC0-24 values of 6.4 μg/ml and 31.6 μg · h/ml, respectively, and only 13.3% bioavailability reduction. No effect of the SLCO1B1 rs4149032 genotype was observed. In conclusion, nutritional supplementation during the first 2 months of TB treatment reduces the decrease in rifampin exposure observed in HIV-coinfected patients but does not affect exposure in HIV-uninfected patients. If confirmed in other studies, the use of defined nutritional supplementation in HIV-coinfected TB patients should be considered in TB control programs. (This study has the controlled trial registration number ISRCTN 16552219.).

U2 - 10.1128/AAC.02307-13

DO - 10.1128/AAC.02307-13

M3 - Journal article

C2 - 24709267

SN - 0066-4804

VL - 58

SP - 3468

EP - 3474

JO - Antimicrobial Agents and Chemotherapy

JF - Antimicrobial Agents and Chemotherapy

IS - 6

ER -

Nutritional supplementation increases Rifampin exposure among tuberculosis patients coinfected with HIV

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