The object of this study is to evaluate the pharmacokinetic interactions, short term safety and efficacy of standard dose lopinavir/ritonavir 200mg/50 (two tablets twice daily) given with ritonavir 100 mg three tablets twice daily given in combination with rifampin in HIV-infected persons with tuberculosis
This will be an open label non-randomized pharmacokinetic study of 10-12 HIV-infected patients co-infected with Mycobacterium tuberculosis. Enrollment: Potential subjects with active tuberculosis who have tolerated a rifampin containing regimen for at least 2 weeks. Potential subjects will be referred from the surrounding communities to Laboratorio de Pesquisa Clinica em Micobacterioses(LAPCLINTB) Visit 1: Subjects will then be started on lopinavir/ritonavir containing HAART regimen with standard twice daily dosing. Ritonavir 100 mg capsules will be added to the regimen and the dose escalated until the patient is taking 3 capsules twice daily. The time between enrollment and visit 1 will be determined by the treating physician. Visit 2: They will return about 1 week after dose escalation has been completed to sample lopinavir and rifampin concentrations. Visit 3: Subject will return in 2 weeks to have repeat to review results of lopinavir concentrations and response to therapy. Ritonavir will be adjusted as needed. Visit 4: Subject will then return in 4 weeks for last visit for evaluation. Lopinavir and rifampin PK will be done.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
9
Two tablets twice daily of Lopinavir/ritonavir 200 mg/50mg with 3 capsules of ritonavir 100 mg twice daily given with rifampin 600 mg daily
Instituto Nacional de Infectologia Evandro Chagas - Fiocruz(INI), Laboratorio de Pesquisa Clinica em Micobacterioses(LAPCLINTB)
Rio de Janeiro, Rio de Janeiro, Brazil
Proportion of patients with expected pre dose concentration of lopinavir.
The expected pre dose concentration of lopinavir is \>1.0 mcg/mL.
Time frame: Weeks 2 and 8: lopinavir time points at hours 0, 2, 4, 6 and 8.
Proportion of patients with successful treatment of HIV therapy.
HIV failure will be defined as failure to drop the viral load by 0.5 log 10 copies/mL drop by week 4 of treatment and a viral load drop \>1 log 10 copies/ml by week 8.
Time frame: Approximately 10-12 weeks
Proportion of patients with expected AUC of rifampin
The expected AUC of rifampin is 44-70 mcg•h/mL
Time frame: Approximatley 10-12 weeks
Proportion of patient with success of tuberculosis therapy
Success of treatment using criteria established by the Brazilian National Ttuberculosis Program.
Time frame: Approximatly 10-12 weeks
Proportion of patients with expected Cmax and AUC of lopinavir
The expected Cmax of lopinavir is 6-14 mcg/mL. The expected AUC lopinavir is 56-130 µg•h/mL
Time frame: 10-12 weeks
Proportion of patients with expected Cmax of rifampin.
Expected maximum concentration of rifampin is 8-24 mcg/mL
Time frame: Weeks 2 and 8: rifampin time points at hours 0, 2, 4, 6 and 8.
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