Clinical considerations and pharmacokinetic interactions between HIV and tuberculosis therapeutics.

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Expert Review of Clinical Pharmacology Pub Date : 2024-07-01 Epub Date: 2024-02-14 DOI:10.1080/17512433.2024.2317954

Nicole F Maranchick, Awewura Kwara, Charles A Peloquin

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引用次数: 0

Abstract

Introduction: Tuberculosis (TB) is a leading infectious disease cause of mortality worldwide, especially for people living with human immunodeficiency virus (PLWH). Treating TB in PLWH can be challenging due to numerous drug interactions.

Areas covered: This review discusses drug interactions between antitubercular and antiretroviral drugs. Due to its clinical importance, initiation of antiretroviral therapy in patients requiring TB treatment is discussed. Special focus is placed on the rifamycin class, as it accounts for the majority of interactions. Clinically relevant guidance is provided on how to manage these interactions. An additional section on utilizing therapeutic drug monitoring (TDM) to optimize drug exposure and minimize toxicities is included.

Expert opinion: Antitubercular and antiretroviral coadministration can be successfully managed. TDM can be used to optimize drug exposure and minimize toxicity risk. As new TB and HIV drugs are discovered, additional research will be needed to assess for clinically relevant drug interactions.

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临床考虑因素和艾滋病毒与结核病治疗药物之间的药代动力学相互作用。

简介结核病（TB）是导致全球死亡的主要传染病，尤其是对人类免疫缺陷病毒感染者（PLWH）而言。由于多种药物相互作用，治疗 PLWH 中的结核病具有挑战性：本综述讨论了抗结核药物与抗逆转录病毒药物之间的相互作用。由于其临床重要性，本文讨论了需要接受结核病治疗的患者开始抗逆转录病毒治疗的问题。本文特别关注利福霉素类药物，因为该类药物占相互作用的大多数。就如何处理这些相互作用提供了临床相关指导。此外，还加入了关于利用治疗药物监测（TDM）优化药物暴露和减少毒性的章节：专家观点：抗结核药物和抗逆转录病毒药物的联合用药可以成功控制。专家观点：抗结核药物和抗逆转录病毒药物的联合用药可成功管理，TDM 可用于优化药物暴露和降低毒性风险。随着结核病和艾滋病新药的发现，需要开展更多的研究，以评估与临床相关的药物相互作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Clinical Pharmacology PHARMACOLOGY & PHARMACY-

CiteScore

7.30

自引率

2.30%

发文量

127

期刊介绍： Advances in drug development technologies are yielding innovative new therapies, from potentially lifesaving medicines to lifestyle products. In recent years, however, the cost of developing new drugs has soared, and concerns over drug resistance and pharmacoeconomics have come to the fore. Adverse reactions experienced at the clinical trial level serve as a constant reminder of the importance of rigorous safety and toxicity testing. Furthermore the advent of pharmacogenomics and ‘individualized’ approaches to therapy will demand a fresh approach to drug evaluation and healthcare delivery. Clinical Pharmacology provides an essential role in integrating the expertise of all of the specialists and players who are active in meeting such challenges in modern biomedical practice.