Tuberculosis Drug Interferes With HIV Treatment, JAMA Study Says
August 5, 2008
The antiretroviral drug nevirapine is less effective in people with HIV/tuberculosis coinfection who begin taking nevirapine at the same time as the TB treatment rifampicin, according to a study published in Wednesday's HIV/AIDS-themed issue of the Journal of the American Medical Association and released at the XVII International AIDS Conference in Mexico City, BBC News reports.
According to AFP/Herald Sun, the study's findings are important because approximately one-third of people living with HIV/AIDS also have TB, and the death rate among people with HIV/TB coinfection is five times greater than among those with only TB (AFP/Melbourne Herald Sun, 8/4). The findings also are important because physicians in developing countries often initiate antiretroviral therapy in TB clinics because TB is common among people living with HIV/AIDS, BBC News reports. In addition, nevirapine is commonly used as a first-line antiretroviral in developing countries because it is inexpensive and safe for pregnant women (BBC News, 8/4).
According to Boulle, it is unclear why rifampicin has an impact on nevirapine, but it is possible that the drugs have a shared toxicity when used in combination or that rifampicin induces a drug reaction when patients begin antiretroviral treatment (AFP/Melbourne Herald Sun, 8/4). Boulle said that further research on the interaction between nevirapine and rifampicin is needed given Africa's reliance on nevirapine-based therapies and the importance of treating TB in people with HIV/TB coinfection. Boulle added that a "striking" aspect of the study is that 40% of HIV-positive individuals starting antiretroviral treatment have concurrent TB, which "underscore[es] the public health importance of improving affordable treatment options" for patients with HIV/TB coinfection.
John Howson, associate director of the International HIV/AIDS Alliance, said that the study demonstrated that antiretroviral therapy may "compromise" TB treatment but added that "this needs more research" (BBC News, 8/4).
An abstract of the study is available online.
Kaisernetwork.org is the official webcaster of the XVII International AIDS Conference in Mexico City. Click here to sign up for your Daily Update e-mail during the conference. A webcast of the opening press conference is available online at kaisernetwork.org.
This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.