|
|
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result sql = Administration of efavirenz (600 mg/day) with rifampicin results in highly variable levels but excellent clinical outcomes in patients treated for tuberculosis and HIV.
Administration of efavirenz (600 mg/day) with rifampicin results in highly variable levels but excellent clinical outcomes in patients treated for tuberculosis and HIV.char = <;code = 60
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char = 3;code = 51
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char = l;code = 108
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char = e;code = 101
char = i;code = 105
char = g;code = 103
char = h;code = 104
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char = e;code = 101
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char = 4;code = 52
char = 5;code = 53
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char = l;code = 108
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char = 5;code = 53
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char = 7;code = 55
char = 5;code = 53
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char = 1;code = 49
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char = c;code = 99
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char = p;code = 112
char = i;code = 105
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char = s;code = 115
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char = m;code = 109
char = L;code = 76
char = ;code = 32
char = a;code = 97
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char = d;code = 100
char = ;code = 32
char = C;code = 67
char = D;code = 68
char = 4;code = 52
char = ;code = 32
char = 2;code = 50
char = 3;code = 51
char = 0;code = 48
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char = c;code = 99
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char = l;code = 108
char = l;code = 108
char = s;code = 115
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char = m;code = 109
char = m;code = 109
char = 3;code = 51
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char = .;code = 46
char = ;code = 32
char = S;code = 83
char = e;code = 101
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char = e;code = 101
char = n;code = 110
char = t;code = 116
char = y;code = 121
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char = t;code = 116
char = w;code = 119
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char = e;code = 101
char = f;code = 102
char = a;code = 97
char = v;code = 118
char = i;code = 105
char = r;code = 114
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char = n;code = 110
char = z;code = 122
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char = c;code = 99
char = o;code = 111
char = n;code = 110
char = c;code = 99
char = e;code = 101
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char = t;code = 116
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
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char = s;code = 115
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char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = v;code = 118
char = a;code = 97
char = i;code = 105
char = l;code = 108
char = a;code = 97
char = b;code = 98
char = l;code = 108
char = e;code = 101
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char = f;code = 102
char = r;code = 114
char = o;code = 111
char = m;code = 109
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char = 1;code = 49
char = 9;code = 57
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
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char = s;code = 115
char = ;code = 32
char = (;code = 40
char = 5;code = 53
char = 8;code = 56
char = ;code = 32
char = o;code = 111
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char = ,;code = 44
char = ;code = 32
char = 1;code = 49
char = 4;code = 52
char = ;code = 32
char = a;code = 97
char = f;code = 102
char = t;code = 116
char = e;code = 101
char = r;code = 114
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char = r;code = 114
char = i;code = 105
char = f;code = 102
char = a;code = 97
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char = p;code = 112
char = i;code = 105
char = c;code = 99
char = i;code = 105
char = n;code = 110
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char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = e;code = 101
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char = g;code = 103
char = e;code = 101
char = o;code = 111
char = m;code = 109
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char = t;code = 116
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char = i;code = 105
char = c;code = 99
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char = m;code = 109
char = e;code = 101
char = a;code = 97
char = n;code = 110
char = ;code = 32
char = e;code = 101
char = f;code = 102
char = a;code = 97
char = v;code = 118
char = i;code = 105
char = r;code = 114
char = e;code = 101
char = n;code = 110
char = z;code = 122
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char = n;code = 110
char = c;code = 99
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char = t;code = 116
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
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char = ;code = 32
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = 1;code = 49
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char = 3;code = 51
char = 0;code = 48
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char = n;code = 110
char = g;code = 103
char = /;code = 47
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char = L;code = 76
char = ;code = 32
char = (;code = 40
char = r;code = 114
char = a;code = 97
char = n;code = 110
char = g;code = 103
char = e;code = 101
char = ;code = 32
char = 3;code = 51
char = 5;code = 53
char = 4;code = 52
char = -;code = 45
char = 2;code = 50
char = 7;code = 55
char = ,;code = 44
char = 1;code = 49
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char = 9;code = 57
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char = ;code = 32
char = o;code = 111
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char = ;code = 32
char = a;code = 97
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char = d;code = 100
char = ;code = 32
char = 1;code = 49
char = 3;code = 51
char = 7;code = 55
char = 7;code = 55
char = ;code = 32
char = n;code = 110
char = g;code = 103
char = /;code = 47
char = m;code = 109
char = L;code = 76
char = ;code = 32
char = (;code = 40
char = r;code = 114
char = a;code = 97
char = n;code = 110
char = g;code = 103
char = e;code = 101
char = ;code = 32
char = 5;code = 53
char = 7;code = 55
char = 2;code = 50
char = -;code = 45
char = 3;code = 51
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char = 7;code = 55
char = 5;code = 53
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char = ;code = 32
char = o;code = 111
char = f;code = 102
char = f;code = 102
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char = r;code = 114
char = i;code = 105
char = f;code = 102
char = a;code = 97
char = m;code = 109
char = p;code = 112
char = i;code = 105
char = c;code = 99
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char = n;code = 110
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char = (;code = 40
char = P;code = 80
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char = =;code = 61
char = ;code = 32
char = 0;code = 48
char = .;code = 46
char = 5;code = 53
char = 5;code = 53
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char = .;code = 46
char = ;code = 32
char = I;code = 73
char = n;code = 110
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = -;code = 45
char = s;code = 115
char = u;code = 117
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char = a;code = 97
char = b;code = 98
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char = a;code = 97
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char = r;code = 114
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char = f;code = 102
char = a;code = 97
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char = p;code = 112
char = i;code = 105
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char = C;code = 67
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char = 1;code = 49
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char = %;code = 37
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char = f;code = 102
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char = m;code = 109
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char = d;code = 100
char = i;code = 105
char = a;code = 97
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char = C;code = 67
char = V;code = 86
char = ;code = 32
char = 2;code = 50
char = 4;code = 52
char = %;code = 37
char = );code = 41
char = .;code = 46
char = ;code = 32
char = O;code = 79
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char = e;code = 101
char = r;code = 114
char = ;code = 32
char = h;code = 104
char = a;code = 97
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char = e;code = 101
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char = a;code = 97
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char = u;code = 117
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char = a;code = 97
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char = 1;code = 49
char = 0;code = 48
char = 0;code = 48
char = 0;code = 48
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char = m;code = 109
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char = H;code = 72
char = I;code = 73
char = V;code = 86
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char = l;code = 108
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char = m;code = 109
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char = e;code = 101
char = r;code = 114
char = a;code = 97
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char = l;code = 108
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char = 8;code = 56
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char = a;code = 97
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char = i;code = 105
char = v;code = 118
char = e;code = 101
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char = C;code = 67
char = D;code = 68
char = 4;code = 52
char = ;code = 32
char = c;code = 99
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char = l;code = 108
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char = 1;code = 49
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char = c;code = 99
char = e;code = 101
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char = l;code = 108
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result sql = OBJECTIVES : Pharmacokinetic interactions between rifampicin and antiretroviral therapy (ART), including efavirenz, are problematic and need to be better defined to determine proper dose and to be correlated with short-term and long-term clinical outcomes.
PATIENTS AND METHODS : Consenting patients with smear-positive pulmonary TB and HIV received once daily didanosine + lamivudine + efavirenz (600 mg), with rifampicin-containing TB regimen by directly observed therapy and self-administration at TB therapy completion. Trough efavirenz levels were measured by HPLC at 1, 2, 4 and 6 months while on rifampicin and after discontinuation. HIV and TB outcomes were monitored.
RESULTS : Twenty African patients were enrolled [15 female, mean age 31 years, baseline weight 59.4 kg (range 45-97), viral load 5.75 log10 copies/mL and CD4 230 cells/mm3]. Seventy-two efavirenz concentrations were available from 19 patients (58 on, 14 after rifampicin). The geometric mean efavirenz concentration was 1730 ng/mL (range 354-27,179) on and 1377 ng/mL (range 572-3975) off rifampicin (P = 0.55). Inter-subject variability in efavirenz concentrations was greater on rifampicin (CV 157% versus 58% off) with relatively consistent intra-subject variation over time (median CV 24%). Over half of patients had efavirenz concentrations above or below the expected therapeutic range (1000-4000 ng/mL). Efavirenz levels were not predicted by weight or gender and were not associated with HIV clinical outcomes. Overall 80% of patients had non-detectable viral loads at 6 months and 65% at 21 months with a cumulative CD4 cell increase of 196 cells/mm3.
CONCLUSIONS : In this longitudinal study, despite wide variability in plasma efavirenz concentrations during rifampicin administration, excellent clinical outcomes were obtained. In African patients treated for HIV and TB, our data support the routine use of efavirenz at 600 mg/day when receiving rifampicin.
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result sql = Administration of efavirenz (600 mg/day) with rifampicin results in highly variable levels but excellent clinical outcomes in patients treated for tuberculosis and HIV.
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char = v;code = 118
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = o;code = 111
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = ;code = 32
char = d;code = 100
char = a;code = 97
char = i;code = 105
char = l;code = 108
char = y;code = 121
char = ;code = 32
char = d;code = 100
char = i;code = 105
char = d;code = 100
char = a;code = 97
char = n;code = 110
char = o;code = 111
char = s;code = 115
char = i;code = 105
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = +;code = 43
char = ;code = 32
char = l;code = 108
char = a;code = 97
char = m;code = 109
char = i;code = 105
char = v;code = 118
char = u;code = 117
char = d;code = 100
char = i;code = 105
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = +;code = 43
char = ;code = 32
char = e;code = 101
char = f;code = 102
char = a;code = 97
char = v;code = 118
char = i;code = 105
char = r;code = 114
char = e;code = 101
char = n;code = 110
char = z;code = 122
char = ;code = 32
char = (;code = 40
char = 6;code = 54
char = 0;code = 48
char = 0;code = 48
char = ;code = 32
char = m;code = 109
char = g;code = 103
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = r;code = 114
char = i;code = 105
char = f;code = 102
char = a;code = 97
char = m;code = 109
char = p;code = 112
char = i;code = 105
char = c;code = 99
char = i;code = 105
char = n;code = 110
char = -;code = 45
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = t;code = 116
char = a;code = 97
char = i;code = 105
char = n;code = 110
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = T;code = 84
char = B;code = 66
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = g;code = 103
char = i;code = 105
char = m;code = 109
char = e;code = 101
char = n;code = 110
char = ;code = 32
char = b;code = 98
char = y;code = 121
char = ;code = 32
char = d;code = 100
char = i;code = 105
char = r;code = 114
char = e;code = 101
char = c;code = 99
char = t;code = 116
char = l;code = 108
char = y;code = 121
char = ;code = 32
char = o;code = 111
char = b;code = 98
char = s;code = 115
char = e;code = 101
char = r;code = 114
char = v;code = 118
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = r;code = 114
char = a;code = 97
char = p;code = 112
char = y;code = 121
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = s;code = 115
char = e;code = 101
char = l;code = 108
char = f;code = 102
char = -;code = 45
char = a;code = 97
char = d;code = 100
char = m;code = 109
char = i;code = 105
char = n;code = 110
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = T;code = 84
char = B;code = 66
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = r;code = 114
char = a;code = 97
char = p;code = 112
char = y;code = 121
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = m;code = 109
char = p;code = 112
char = l;code = 108
char = e;code = 101
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = r;code = 114
char = o;code = 111
char = u;code = 117
char = g;code = 103
char = h;code = 104
char = ;code = 32
char = e;code = 101
char = f;code = 102
char = a;code = 97
char = v;code = 118
char = i;code = 105
char = r;code = 114
char = e;code = 101
char = n;code = 110
char = z;code = 122
char = ;code = 32
char = l;code = 108
char = e;code = 101
char = v;code = 118
char = e;code = 101
char = l;code = 108
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = a;code = 97
char = s;code = 115
char = u;code = 117
char = r;code = 114
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = b;code = 98
char = y;code = 121
char = ;code = 32
char = H;code = 72
char = P;code = 80
char = L;code = 76
char = C;code = 67
char = ;code = 32
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = 1;code = 49
char = ,;code = 44
char = ;code = 32
char = 2;code = 50
char = ,;code = 44
char = ;code = 32
char = 4;code = 52
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = 6;code = 54
char = ;code = 32
char = m;code = 109
char = o;code = 111
char = n;code = 110
char = t;code = 116
char = h;code = 104
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = h;code = 104
char = i;code = 105
char = l;code = 108
char = e;code = 101
char = ;code = 32
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = r;code = 114
char = i;code = 105
char = f;code = 102
char = a;code = 97
char = m;code = 109
char = p;code = 112
char = i;code = 105
char = c;code = 99
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = a;code = 97
char = f;code = 102
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = ;code = 32
char = d;code = 100
char = i;code = 105
char = s;code = 115
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = t;code = 116
char = i;code = 105
char = n;code = 110
char = u;code = 117
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = .;code = 46
char = ;code = 32
char = H;code = 72
char = I;code = 73
char = V;code = 86
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = T;code = 84
char = B;code = 66
char = ;code = 32
char = o;code = 111
char = u;code = 117
char = t;code = 116
char = c;code = 99
char = o;code = 111
char = m;code = 109
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = m;code = 109
char = o;code = 111
char = n;code = 110
char = i;code = 105
char = t;code = 116
char = o;code = 111
char = r;code = 114
char = e;code = 101
char = d;code = 100
char = .;code = 46
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = >;code = 62
char = R;code = 82
char = E;code = 69
char = S;code = 83
char = U;code = 85
char = L;code = 76
char = T;code = 84
char = S;code = 83
char = ;code = 32
char = :;code = 58
char = ;code = 32
char = <;code = 60
char = /;code = 47
char = b;code = 98
char = >;code = 62
char = T;code = 84
char = w;code = 119
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = A;code = 65
char = f;code = 102
char = r;code = 114
char = i;code = 105
char = c;code = 99
char = a;code = 97
char = n;code = 110
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = e;code = 101
char = n;code = 110
char = r;code = 114
char = o;code = 111
char = l;code = 108
char = l;code = 108
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = [;code = 91
char = 1;code = 49
char = 5;code = 53
char = ;code = 32
char = f;code = 102
char = e;code = 101
char = m;code = 109
char = a;code = 97
char = l;code = 108
char = e;code = 101
char = ,;code = 44
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = a;code = 97
char = n;code = 110
char = ;code = 32
char = a;code = 97
char = g;code = 103
char = e;code = 101
char = ;code = 32
char = 3;code = 51
char = 1;code = 49
char = ;code = 32
char = y;code = 121
char = e;code = 101
char = a;code = 97
char = r;code = 114
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = b;code = 98
char = a;code = 97
char = s;code = 115
char = e;code = 101
char = l;code = 108
char = i;code = 105
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = i;code = 105
char = g;code = 103
char = h;code = 104
char = t;code = 116
char = ;code = 32
char = 5;code = 53
char = 9;code = 57
char = .;code = 46
char = 4;code = 52
char = ;code = 32
char = k;code = 107
char = g;code = 103
char = ;code = 32
char = (;code = 40
char = r;code = 114
char = a;code = 97
char = n;code = 110
char = g;code = 103
char = e;code = 101
char = ;code = 32
char = 4;code = 52
char = 5;code = 53
char = -;code = 45
char = 9;code = 57
char = 7;code = 55
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = v;code = 118
char = i;code = 105
char = r;code = 114
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = l;code = 108
char = o;code = 111
char = a;code = 97
char = d;code = 100
char = ;code = 32
char = 5;code = 53
char = .;code = 46
char = 7;code = 55
char = 5;code = 53
char = ;code = 32
char = l;code = 108
char = o;code = 111
char = g;code = 103
char = 1;code = 49
char = 0;code = 48
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = p;code = 112
char = i;code = 105
char = e;code = 101
char = s;code = 115
char = /;code = 47
char = m;code = 109
char = L;code = 76
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = C;code = 67
char = D;code = 68
char = 4;code = 52
char = ;code = 32
char = 2;code = 50
char = 3;code = 51
char = 0;code = 48
char = ;code = 32
char = c;code = 99
char = e;code = 101
char = l;code = 108
char = l;code = 108
char = s;code = 115
char = /;code = 47
char = m;code = 109
char = m;code = 109
char = 3;code = 51
char = ];code = 93
char = .;code = 46
char = ;code = 32
char = S;code = 83
char = e;code = 101
char = v;code = 118
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = y;code = 121
char = -;code = 45
char = t;code = 116
char = w;code = 119
char = o;code = 111
char = ;code = 32
char = e;code = 101
char = f;code = 102
char = a;code = 97
char = v;code = 118
char = i;code = 105
char = r;code = 114
char = e;code = 101
char = n;code = 110
char = z;code = 122
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = v;code = 118
char = a;code = 97
char = i;code = 105
char = l;code = 108
char = a;code = 97
char = b;code = 98
char = l;code = 108
char = e;code = 101
char = ;code = 32
char = f;code = 102
char = r;code = 114
char = o;code = 111
char = m;code = 109
char = ;code = 32
char = 1;code = 49
char = 9;code = 57
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = (;code = 40
char = 5;code = 53
char = 8;code = 56
char = ;code = 32
char = o;code = 111
char = n;code = 110
char = ,;code = 44
char = ;code = 32
char = 1;code = 49
char = 4;code = 52
char = ;code = 32
char = a;code = 97
char = f;code = 102
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = ;code = 32
char = r;code = 114
char = i;code = 105
char = f;code = 102
char = a;code = 97
char = m;code = 109
char = p;code = 112
char = i;code = 105
char = c;code = 99
char = i;code = 105
char = n;code = 110
char = );code = 41
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = g;code = 103
char = e;code = 101
char = o;code = 111
char = m;code = 109
char = e;code = 101
char = t;code = 116
char = r;code = 114
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = a;code = 97
char = n;code = 110
char = ;code = 32
char = e;code = 101
char = f;code = 102
char = a;code = 97
char = v;code = 118
char = i;code = 105
char = r;code = 114
char = e;code = 101
char = n;code = 110
char = z;code = 122
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = 1;code = 49
char = 7;code = 55
char = 3;code = 51
char = 0;code = 48
char = ;code = 32
char = n;code = 110
char = g;code = 103
char = /;code = 47
char = m;code = 109
char = L;code = 76
char = ;code = 32
char = (;code = 40
char = r;code = 114
char = a;code = 97
char = n;code = 110
char = g;code = 103
char = e;code = 101
char = ;code = 32
char = 3;code = 51
char = 5;code = 53
char = 4;code = 52
char = -;code = 45
char = 2;code = 50
char = 7;code = 55
char = ,;code = 44
char = 1;code = 49
char = 7;code = 55
char = 9;code = 57
char = );code = 41
char = ;code = 32
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = 1;code = 49
char = 3;code = 51
char = 7;code = 55
char = 7;code = 55
char = ;code = 32
char = n;code = 110
char = g;code = 103
char = /;code = 47
char = m;code = 109
char = L;code = 76
char = ;code = 32
char = (;code = 40
char = r;code = 114
char = a;code = 97
char = n;code = 110
char = g;code = 103
char = e;code = 101
char = ;code = 32
char = 5;code = 53
char = 7;code = 55
char = 2;code = 50
char = -;code = 45
char = 3;code = 51
char = 9;code = 57
char = 7;code = 55
char = 5;code = 53
char = );code = 41
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = f;code = 102
char = ;code = 32
char = r;code = 114
char = i;code = 105
char = f;code = 102
char = a;code = 97
char = m;code = 109
char = p;code = 112
char = i;code = 105
char = c;code = 99
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = (;code = 40
char = P;code = 80
char = ;code = 32
char = =;code = 61
char = ;code = 32
char = 0;code = 48
char = .;code = 46
char = 5;code = 53
char = 5;code = 53
char = );code = 41
char = .;code = 46
char = ;code = 32
char = I;code = 73
char = n;code = 110
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = -;code = 45
char = s;code = 115
char = u;code = 117
char = b;code = 98
char = j;code = 106
char = e;code = 101
char = c;code = 99
char = t;code = 116
char = ;code = 32
char = v;code = 118
char = a;code = 97
char = r;code = 114
char = i;code = 105
char = a;code = 97
char = b;code = 98
char = i;code = 105
char = l;code = 108
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = e;code = 101
char = f;code = 102
char = a;code = 97
char = v;code = 118
char = i;code = 105
char = r;code = 114
char = e;code = 101
char = n;code = 110
char = z;code = 122
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = g;code = 103
char = r;code = 114
char = e;code = 101
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = ;code = 32
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = r;code = 114
char = i;code = 105
char = f;code = 102
char = a;code = 97
char = m;code = 109
char = p;code = 112
char = i;code = 105
char = c;code = 99
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = (;code = 40
char = C;code = 67
char = V;code = 86
char = ;code = 32
char = 1;code = 49
char = 5;code = 53
char = 7;code = 55
char = %;code = 37
char = ;code = 32
char = v;code = 118
char = e;code = 101
char = r;code = 114
char = s;code = 115
char = u;code = 117
char = s;code = 115
char = ;code = 32
char = 5;code = 53
char = 8;code = 56
char = %;code = 37
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = f;code = 102
char = );code = 41
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = l;code = 108
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = l;code = 108
char = y;code = 121
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = n;code = 110
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = -;code = 45
char = s;code = 115
char = u;code = 117
char = b;code = 98
char = j;code = 106
char = e;code = 101
char = c;code = 99
char = t;code = 116
char = ;code = 32
char = v;code = 118
char = a;code = 97
char = r;code = 114
char = i;code = 105
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = o;code = 111
char = v;code = 118
char = e;code = 101
char = r;code = 114
char = ;code = 32
char = t;code = 116
char = i;code = 105
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result sql = OBJECTIVES : Pharmacokinetic interactions between rifampicin and antiretroviral therapy (ART), including efavirenz, are problematic and need to be better defined to determine proper dose and to be correlated with short-term and long-term clinical outcomes.
PATIENTS AND METHODS : Consenting patients with smear-positive pulmonary TB and HIV received once daily didanosine + lamivudine + efavirenz (600 mg), with rifampicin-containing TB regimen by directly observed therapy and self-administration at TB therapy completion. Trough efavirenz levels were measured by HPLC at 1, 2, 4 and 6 months while on rifampicin and after discontinuation. HIV and TB outcomes were monitored.
RESULTS : Twenty African patients were enrolled [15 female, mean age 31 years, baseline weight 59.4 kg (range 45-97), viral load 5.75 log10 copies/mL and CD4 230 cells/mm3]. Seventy-two efavirenz concentrations were available from 19 patients (58 on, 14 after rifampicin). The geometric mean efavirenz concentration was 1730 ng/mL (range 354-27,179) on and 1377 ng/mL (range 572-3975) off rifampicin (P = 0.55). Inter-subject variability in efavirenz concentrations was greater on rifampicin (CV 157% versus 58% off) with relatively consistent intra-subject variation over time (median CV 24%). Over half of patients had efavirenz concentrations above or below the expected therapeutic range (1000-4000 ng/mL). Efavirenz levels were not predicted by weight or gender and were not associated with HIV clinical outcomes. Overall 80% of patients had non-detectable viral loads at 6 months and 65% at 21 months with a cumulative CD4 cell increase of 196 cells/mm3.
CONCLUSIONS : In this longitudinal study, despite wide variability in plasma efavirenz concentrations during rifampicin administration, excellent clinical outcomes were obtained. In African patients treated for HIV and TB, our data support the routine use of efavirenz at 600 mg/day when receiving rifampicin.
Publication: J. Antimicrob. Chemother. 2006 Dec ;58(6)::1299-302.
Publication Date: 2006 Dec
Study Author(s): Friedland, Gerald;Khoo, Saye;Jack, Christopher;Lalloo, Umesh;
Institution: Yale University School of Medicine AIDS Program, New Haven, CT 06510-2483, USA. [email protected]
Shortcut link to this study:
Publication Date: 2006 Dec
Study Author(s): Friedland, Gerald;Khoo, Saye;Jack, Christopher;Lalloo, Umesh;
Institution: Yale University School of Medicine AIDS Program, New Haven, CT 06510-2483, USA. [email protected]
Shortcut link to this study:
OBJECTIVES : Pharmacokinetic interactions between rifampicin and antiretroviral therapy (ART), including efavirenz, are problematic and need to be better defined to determine proper dose and to be correlated with short-term and long-term clinical outcomes.
PATIENTS AND METHODS : Consenting patients with smear-positive pulmonary TB and HIV received once daily didanosine + lamivudine + efavirenz (600 mg), with rifampicin-containing TB regimen by directly observed therapy and self-administration at TB therapy completion. Trough efavirenz levels were measured by HPLC at 1, 2, 4 and 6 months while on rifampicin and after discontinuation. HIV and TB outcomes were monitored.
RESULTS : Twenty African patients were enrolled [15 female, mean age 31 years, baseline weight 59.4 kg (range 45-97), viral load 5.75 log10 copies/mL and CD4 230 cells/mm3]. Seventy-two efavirenz concentrations were available from 19 patients (58 on, 14 after rifampicin). The geometric mean efavirenz concentration was 1730 ng/mL (range 354-27,179) on and 1377 ng/mL (range 572-3975) off rifampicin (P = 0.55). Inter-subject variability in efavirenz concentrations was greater on rifampicin (CV 157% versus 58% off) with relatively consistent intra-subject variation over time (median CV 24%). Over half of patients had efavirenz concentrations above or below the expected therapeutic range (1000-4000 ng/mL). Efavirenz levels were not predicted by weight or gender and were not associated with HIV clinical outcomes. Overall 80% of patients had non-detectable viral loads at 6 months and 65% at 21 months with a cumulative CD4 cell increase of 196 cells/mm3.
CONCLUSIONS : In this longitudinal study, despite wide variability in plasma efavirenz concentrations during rifampicin administration, excellent clinical outcomes were obtained. In African patients treated for HIV and TB, our data support the routine use of efavirenz at 600 mg/day when receiving rifampicin.
PATIENTS AND METHODS : Consenting patients with smear-positive pulmonary TB and HIV received once daily didanosine + lamivudine + efavirenz (600 mg), with rifampicin-containing TB regimen by directly observed therapy and self-administration at TB therapy completion. Trough efavirenz levels were measured by HPLC at 1, 2, 4 and 6 months while on rifampicin and after discontinuation. HIV and TB outcomes were monitored.
RESULTS : Twenty African patients were enrolled [15 female, mean age 31 years, baseline weight 59.4 kg (range 45-97), viral load 5.75 log10 copies/mL and CD4 230 cells/mm3]. Seventy-two efavirenz concentrations were available from 19 patients (58 on, 14 after rifampicin). The geometric mean efavirenz concentration was 1730 ng/mL (range 354-27,179) on and 1377 ng/mL (range 572-3975) off rifampicin (P = 0.55). Inter-subject variability in efavirenz concentrations was greater on rifampicin (CV 157% versus 58% off) with relatively consistent intra-subject variation over time (median CV 24%). Over half of patients had efavirenz concentrations above or below the expected therapeutic range (1000-4000 ng/mL). Efavirenz levels were not predicted by weight or gender and were not associated with HIV clinical outcomes. Overall 80% of patients had non-detectable viral loads at 6 months and 65% at 21 months with a cumulative CD4 cell increase of 196 cells/mm3.
CONCLUSIONS : In this longitudinal study, despite wide variability in plasma efavirenz concentrations during rifampicin administration, excellent clinical outcomes were obtained. In African patients treated for HIV and TB, our data support the routine use of efavirenz at 600 mg/day when receiving rifampicin.
PMID: 17032686
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