BACKGROUND

Reports suggest that antituberculosis drugs are malabsorbed in patients with advanced HIV disease.

OBJECTIVE

To evaluate the pharmacokinetics of antituberculosis agents in HIV-seropositive patients at different stages of disease.

METHODS

Parallel study.

METHODS

Two hospital outpatient clinics.

METHODS

12 healthy volunteers, 12 patients with asymptomatic HIV disease, 12 patients with symptomatic HIV disease, and 12 patients with symptomatic HIV disease and diarrhea.

METHODS

Drug plasma concentrations were measured over 24 hours on day 4 of concurrent therapy.

METHODS

Oral isoniazid (300 mg/d), rifampin (600 mg/d), pyrazinamide (1000 mg/d), and ethambutol (1000 mg/d).

RESULTS

Reduced total drug exposure to rifampin and pyrazinamide was associated with D-xylose malabsorption in persons with HIV infection or AIDS. Peak drug exposure to isoniazid was lower in patients with diarrhea.

CONCLUSIONS

Reduced total drug exposure may be related to malabsorption in persons with HIV infection or AIDS.