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Journal Article
|Research

Double-dose lopinavir-ritonavir in combination with rifampicin-based anti-tuberculosis treatment in South Africa

Sunpath H, Winternheimer P, Cohen S, Tennant I, Chelin N, Ghandhi RT

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Abstract
BACKGROUND
The optimal treatment for tuberculosis (TB) in human immunodeficiency virus (HIV) infected patients in resource-poor settings receiving lopinavir-ritonavir (LPV/r) based second-line antiretroviral therapy (ART) has yet to be determined. In South Africa, clinicians are advised to use 'double-dose' LPV/r dosed at 800 mg/200 mg twice daily during anti-tuberculosis treatment.

METHODOLOGY AND FINDINGS
We conducted a retrospective study of HIV-infected patients who received ≥2 months of double-dose LPV/r-based ART during concomitant rifampicin-containing anti-tuberculosis treatment. We used standard definitions for TB and HIV outcomes; virological failure was defined as a viral load >1000 copies/ml. During co-administration, gastrointestinal toxicity occurred in 9/25 (36%) patients, a symptomatic rise in aspartate aminotransferase or alanine aminotransferase of any grade was noted in 3 (12%), with two Grade 3 events, and 3 (12%) patients required treatment discontinuation. Outcomes were favourable, with 20/25 (80%) patients achieving TB treatment success and virological failure observed among 3 (12%) patients during co-administration.

CONCLUSION
We found the use of double-dose LPV/r during simultaneous standard anti-tuberculosis treatment to be an effective and reasonably well tolerated interim strategy.

Countries

South Africa

Subject Area

tuberculosisHIV/AIDS

Languages

English
DOI
10.5588/ijtld.13.0492
Published Date
01 Jun 2014
PubMed ID
24903940
Journal
International Journal of Tuberculosis and Lung Disease
Volume | Issue | Pages
Volume 18, Issue 6, Pages 689-93
Issue Date
2014-06-01
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Double-dose lopinavir-ritonavir in combination with rifampicin-based anti-tuberculosis treatment in South Africa | Journal Article / Research | MSF Science Portal