Mark Mascolini

No oral cabotegravir dose adjustment expected with rifabutin

Coadministered rifabutin modestly lowered plasma levels of oral cabotegravir and left cabotegravir troughs above those that maintain viral suppression with a 10-mg oral dose [1]. Simulations will be done to estimate the impact of rifabutin on long-acting injected cabotegravir.

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Restored TB-specific CD4 response linked to TB-IRIS soon after ART starts

Recovery of polyfunctional TB-specific CD4 cells boosted chances of tuberculosis immune reconstitution inflammatory syndrome (TB-IRIS) after antiretroviral therapy (ART) began in a case-control study of 143 people with active TB [1]. The finding adds to the understanding of this dangerous syndrome in people starting ART with active TB.

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High risk of rifampicin resistance with HIV in 3-group Indian study

HIV-positive people not taking antiretroviral therapy (ART) had a 21 times higher risk of acquiring resistance to rifampicin than did HIV-negative people taking the same anti-TB regimen in an Indian study. Taking ART lowered but did not eliminate the increased resistance risk.

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People with HIV account for over 60% of TB cases in Southern Africa

Slightly more than 60% of tuberculosis disease cases in southern Africa occur in people with HIV infection, according to a regional analysis of TB numbers. Across the world, people with HIV account for 21% of all TB deaths.

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Isoniazid, d-drugs, weight, boost neuropathy risk in African trial

Isoniazid, stavudine (d4T), didanosine (ddI), higher weight, and older age all raised the risk of peripheral neuropathy in adults starting antiretroviral therapy (ART) in Uganda and Zimbabwe. Gender and pre-ART CD4 count did not affect chances of neuropathy in these DART trial participants.

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Xpert TB takes twice longer than standard TB test in HIV+ of Durban

Xpert MTB/RIF testing for pulmonary tuberculosis in a central lab took twice longer than sputum smear microscopy among HIV-positive patients with suspected pulmonary TB in Durban, South Africa. The authors believe Xpert results in “operational delays that limit the test's clinical utility for diagnosing pulmonary TB” in their patients.

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IRIS uncommon when ART starts in 96,000-person Europe/US study

Immune reconstitution inflammatory syndrome (IRIS) appears to be rare when antiretroviral-naive adults in Europe and the United States start ART, with the possible exception of mycobacterial infections.

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Risk of MDR-TB rises with ongoing treatment in 9 countries

Risk of further resistance to TB drugs rose with ongoing treatment of multidrug-resistant (MDR) TB, according to results of a 9-country analysis. Risk of further resistance was about 75% to 80% lower in countries that met international Green Light Committee (GLC) criteria.

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TB therapy does not affect ART response in South African children

Receiving therapy for tuberculosis when starting a first antiretroviral therapy (ART) regimen did not affect virologic or CD4 response to that regimen in a study of 199 South African children. Responses appeared to be worse with lopinavir/ritonavir than with efavirenz in children taking TB therapy when ART began.

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In Rio group over 10% diagnosed with HIV also have tuberculosis

Slightly more than 10% in a Rio de Janeiro cohort with newly diagnosed HIV infection already had tuberculosis, according to results of a 4500-person study. Although antiretroviral therapy (ART) started faster in the people with than without TB, those with TB had almost a 75% higher early death risk.

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