Khayelitsha Hospital TB study pharmacokinetic variables: Non compartmental analysis
datasetposted on 13.08.2019, 10:02 authored by Charlotte SchutzCharlotte Schutz, Maxwell ChirehwaMaxwell Chirehwa, David Barr, Amy Ward, Saskia Janssen, Rosie Burton, Robert J. Wilkinson, Muki Shey, Lubbe Wiesner, Paolo Denti, Helen McIlleron, Gary MaartensGary Maartens, Graeme Meintjes
Human immunodeficiency virus associated tuberculosis (HIV-TB) comprise 10% of global tuberculosis cases but contribute a disproportionate 22% of global tuberculosis mortality. HIV-infected patients hospitalized with HIV-TB have high high case fatality rates despite treatment and often present with a clinical picture compatible with sepsis. There is paucity of data in critically ill HIV-infected patients admitted to hospital at the time of tuberculosis diagnosis. Improved, evidence-based treatment interventions in this patient group are urgently needed to improve survival.
We performed intensive pharmacokinetic studies (from 0-8 hours) in a high burden setting (Khayelitsha Hospital, Cape Town), within the routine service. We assessed rifampicin, isoniazid and pyrazinamide exposure in a group of hospitalized HIV-TB patients and a group of outpatients on the third day of standard antituberculosis therapy using non-compartmental analysis. We followed hospitalized patients for 12 weeks to asses survival. We compared pharmacokinetic exposures in hospitalized patients and outpatients; hospitalized patients who survived twelve weeks and those who died; and hospitalized patients presenting with high lactate (more than 2.2 mmol/L) and patient presenting with normal lactate.