Pharmacokinetics of antiretroviral and tuberculosis drugs in children with HIV/TB co-infection : a systematic review
© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy..
INTRODUCTION: Management of concomitant use of ART and TB drugs is difficult because of the many drug-drug interactions (DDIs) between the medications. This systematic review provides an overview of the current state of knowledge about the pharmacokinetics (PK) of ART and TB treatment in children with HIV/TB co-infection, and identifies knowledge gaps.
METHODS: We searched Embase and PubMed, and systematically searched abstract books of relevant conferences, following PRISMA guidelines. Studies not reporting PK parameters, investigating medicines that are not available any longer or not including children with HIV/TB co-infection were excluded. All studies were assessed for quality.
RESULTS: In total, 47 studies met the inclusion criteria. No dose adjustments are necessary for efavirenz during concomitant first-line TB treatment use, but intersubject PK variability was high, especially in children <3 years of age. Super-boosted lopinavir/ritonavir (ratio 1:1) resulted in adequate lopinavir trough concentrations during rifampicin co-administration. Double-dosed raltegravir can be given with rifampicin in children >4 weeks old as well as twice-daily dolutegravir (instead of once daily) in children older than 6 years. Exposure to some TB drugs (ethambutol and rifampicin) was reduced in the setting of HIV infection, regardless of ART use. Only limited PK data of second-line TB drugs with ART in children who are HIV infected have been published.
CONCLUSIONS: Whereas integrase inhibitors seem favourable in older children, there are limited options for ART in young children (<3 years) receiving rifampicin-based TB therapy. The PK of TB drugs in HIV-infected children warrants further research.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:75 |
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| Enthalten in: |
The Journal of antimicrobial chemotherapy - 75(2020), 12 vom: 01. Dez., Seite 3433-3457 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jacobs, Tom G [VerfasserIn] |
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| Links: |
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| Themen: |
2494G1JF75 |
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| Anmerkungen: |
Date Completed 24.06.2021 Date Revised 12.11.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/jac/dkaa328 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM313604576 |
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| 041 | |a eng | ||
| 100 | 1 | |a Jacobs, Tom G |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Pharmacokinetics of antiretroviral and tuberculosis drugs in children with HIV/TB co-infection |b a systematic review |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 24.06.2021 | ||
| 500 | |a Date Revised 12.11.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. | ||
| 520 | |a INTRODUCTION: Management of concomitant use of ART and TB drugs is difficult because of the many drug-drug interactions (DDIs) between the medications. This systematic review provides an overview of the current state of knowledge about the pharmacokinetics (PK) of ART and TB treatment in children with HIV/TB co-infection, and identifies knowledge gaps | ||
| 520 | |a METHODS: We searched Embase and PubMed, and systematically searched abstract books of relevant conferences, following PRISMA guidelines. Studies not reporting PK parameters, investigating medicines that are not available any longer or not including children with HIV/TB co-infection were excluded. All studies were assessed for quality | ||
| 520 | |a RESULTS: In total, 47 studies met the inclusion criteria. No dose adjustments are necessary for efavirenz during concomitant first-line TB treatment use, but intersubject PK variability was high, especially in children <3 years of age. Super-boosted lopinavir/ritonavir (ratio 1:1) resulted in adequate lopinavir trough concentrations during rifampicin co-administration. Double-dosed raltegravir can be given with rifampicin in children >4 weeks old as well as twice-daily dolutegravir (instead of once daily) in children older than 6 years. Exposure to some TB drugs (ethambutol and rifampicin) was reduced in the setting of HIV infection, regardless of ART use. Only limited PK data of second-line TB drugs with ART in children who are HIV infected have been published | ||
| 520 | |a CONCLUSIONS: Whereas integrase inhibitors seem favourable in older children, there are limited options for ART in young children (<3 years) receiving rifampicin-based TB therapy. The PK of TB drugs in HIV-infected children warrants further research | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Systematic Review | |
| 650 | 7 | |a Anti-HIV Agents |2 NLM | |
| 650 | 7 | |a Pharmaceutical Preparations |2 NLM | |
| 650 | 7 | |a Lopinavir |2 NLM | |
| 650 | 7 | |a 2494G1JF75 |2 NLM | |
| 700 | 1 | |a Svensson, Elin M |e verfasserin |4 aut | |
| 700 | 1 | |a Musiime, Victor |e verfasserin |4 aut | |
| 700 | 1 | |a Rojo, Pablo |e verfasserin |4 aut | |
| 700 | 1 | |a Dooley, Kelly E |e verfasserin |4 aut | |
| 700 | 1 | |a McIlleron, Helen |e verfasserin |4 aut | |
| 700 | 1 | |a Aarnoutse, Rob E |e verfasserin |4 aut | |
| 700 | 1 | |a Burger, David M |e verfasserin |4 aut | |
| 700 | 1 | |a Turkova, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a Colbers, Angela |e verfasserin |4 aut | |
| 700 | 0 | |a WHO Paediatric Antiretroviral Working Group |e verfasserin |4 aut | |
| 700 | 1 | |a Abrams, Elaine |e investigator |4 oth | |
| 700 | 1 | |a Archary, Moherndran |e investigator |4 oth | |
| 700 | 1 | |a Belew, Yodit |e investigator |4 oth | |
| 700 | 1 | |a Best, Brookie |e investigator |4 oth | |
| 700 | 1 | |a Burger, David |e investigator |4 oth | |
| 700 | 1 | |a Burry, Jessica |e investigator |4 oth | |
| 700 | 1 | |a Capparelli, Edmund |e investigator |4 oth | |
| 700 | 1 | |a Carpenter, Deborah |e investigator |4 oth | |
| 700 | 1 | |a Casas, Esther |e investigator |4 oth | |
| 700 | 1 | |a Clayden, Polly |e investigator |4 oth | |
| 700 | 1 | |a Clarke, Diana |e investigator |4 oth | |
| 700 | 1 | |a Cressey, Tim |e investigator |4 oth | |
| 700 | 1 | |a Colbers, Angela |e investigator |4 oth | |
| 700 | 1 | |a Dangarembizi, Mutsa |e investigator |4 oth | |
| 700 | 1 | |a Denti, Paolo |e investigator |4 oth | |
| 700 | 1 | |a Diop, Karim |e investigator |4 oth | |
| 700 | 1 | |a Ecker, Andrea |e investigator |4 oth | |
| 700 | 1 | |a Essajee, Shaffiq |e investigator |4 oth | |
| 700 | 1 | |a Giaquinto, Carlo |e investigator |4 oth | |
| 700 | 1 | |a Gibb, Diana |e investigator |4 oth | |
| 700 | 1 | |a Hazra, Rohan |e investigator |4 oth | |
| 700 | 1 | |a Kim, Maria |e investigator |4 oth | |
| 700 | 1 | |a Lallemant, Marc |e investigator |4 oth | |
| 700 | 1 | |a Lee, Janice |e investigator |4 oth | |
| 700 | 1 | |a Lewis, Linda |e investigator |4 oth | |
| 700 | 1 | |a Lockman, Shahin |e investigator |4 oth | |
| 700 | 1 | |a Mirochnick, Mark |e investigator |4 oth | |
| 700 | 1 | |a Mofenson, Lynne |e investigator |4 oth | |
| 700 | 1 | |a Musiime, Victor |e investigator |4 oth | |
| 700 | 1 | |a Obimbo, Elizabeth |e investigator |4 oth | |
| 700 | 1 | |a Ojoo, Atieno |e investigator |4 oth | |
| 700 | 1 | |a Pascual, Fernando |e investigator |4 oth | |
| 700 | 1 | |a Penazzato, Martina |e investigator |4 oth | |
| 700 | 1 | |a Pinto, Jorge |e investigator |4 oth | |
| 700 | 1 | |a Rakhmanina, Natella |e investigator |4 oth | |
| 700 | 1 | |a Rojo, Pablo |e investigator |4 oth | |
| 700 | 1 | |a Ruel, Ted |e investigator |4 oth | |
| 700 | 1 | |a Siberry, George |e investigator |4 oth | |
| 700 | 1 | |a Sugandhi, Nandita |e investigator |4 oth | |
| 700 | 1 | |a Turkova, Anna |e investigator |4 oth | |
| 700 | 1 | |a Vicari, Marissa |e investigator |4 oth | |
| 700 | 1 | |a Watkins, Melynda |e investigator |4 oth | |
| 700 | 1 | |a Wolf, Hilary |e investigator |4 oth | |
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