Rifamycin-resistant Mycobacterium tuberculosis in the highly active antiretroviral therapy era: a report of 3 relapses with acquired rifampin resistance following alternate-day rifabutin and boosted protease inhibitor therapy.

Abstract

Rifamycin-resistant Mycobacterium tuberculosis infection (i.e., by a strain of M. tuberculosis that is only resistant to rifamycins) occurs disproportionately among patients infected with the human immunodeficiency virus (HIV) who have a low CD4 cell count. We observed 3 genetically confirmed cases of relapse with rifamycin-resistant M. tuberculosis infection following concurrent treatment with rifabutin (dosage, 150 mg every other day) and a ritonavir-boosted HIV protease inhibitor during a prior episode of drug-susceptible tuberculosis. Higher doses of rifabutin and a ritonavir-boosted HIV protease inhibitor as treatment for tuberculosis should be studied further.

• Authors: Elizabeth R Jenny-Avital, Kareen Joseph
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 48 Issue 10 Pg. 1471-4 (May 15 2009) ISSN: 1537-6591 [Electronic] United States
• PMID: 19368504 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-HIV Agents
• Antitubercular Agents
• HIV Protease Inhibitors
• Rifabutin
• Ritonavir

Topics

• Adult
• Anti-HIV Agents (therapeutic use)
• Antiretroviral Therapy, Highly Active
• Antitubercular Agents (pharmacology, therapeutic use)
• Drug Resistance, Bacterial
• HIV Infections (complications, drug therapy)
• HIV Protease Inhibitors (therapeutic use)
• Humans
• Male
• Middle Aged
• Mycobacterium tuberculosis (drug effects, isolation & purification)
• Recurrence
• Rifabutin (pharmacology, therapeutic use)
• Ritonavir (therapeutic use)
• Treatment Outcome
• Tuberculosis (microbiology)