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耐多药肺结核合并 HIV 感染患者中,利福平抗结核治疗时 CYP2B6 516TT 基因型者出现依非韦伦血药浓度升高的矛盾现象。

Paradoxically elevated efavirenz concentrations in HIV/tuberculosis-coinfected patients with CYP2B6 516TT genotype on rifampin-containing antituberculous therapy.

机构信息

The Miriam Hospital, Providence, Rhode Island 02906, USA.

出版信息

AIDS. 2011 Jan 28;25(3):388-90. doi: 10.1097/QAD.0b013e3283427e05.

Abstract

Some individuals have higher efavirenz plasma concentrations during rifampin-containing tuberculosis (TB) therapy, contrary to the expected induction effect of rifampin. Among HIV-infected patients without (n = 38) and with TB on rifampin-containing therapy (n = 18), we tested the hypothesis that drug-gene interaction may explain the highly variable drug interactions. Two-way analysis of variance revealed a significant interaction between CYP2B6 516G→T polymorphism and rifampin-containing therapy, suggesting that efavirenz dose adjustment may need to be individualized on the basis of the patient's genotype.

摘要

在利福平含结核病(TB)治疗期间,一些个体的依非韦伦血浆浓度升高,与利福平预期的诱导作用相反。在未接受(n = 38)和接受利福平含治疗的 HIV 感染患者中(n = 18),我们检验了药物-基因相互作用可能解释这种高度可变的药物相互作用的假设。双向方差分析显示 CYP2B6 516G→T 多态性与利福平含治疗之间存在显著相互作用,表明可能需要根据患者的基因型来个体化调整依非韦伦剂量。

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