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AIDS Res Treat. 2012; 2012: 874083.
Published online Jul 5, 2012. doi:  10.1155/2012/874083
PMCID: PMC3398575
TB and HIV Therapeutics: Pharmacology Research Priorities
Kelly E. Dooley, 1 * Peter S. Kim, 2 Sharon D. Williams, 2 and Richard Hafner 2
1Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Osler 527, Baltimore, MD 21287, USA
2Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
*Kelly E. Dooley: kdooley1/at/jhmi.edu
Academic Editor: Gary Maartens
Received January 26, 2012; Accepted March 13, 2012.
Abstract
An unprecedented number of investigational drugs are in the development pipeline for the treatment of tuberculosis. Among patients with tuberculosis, co-infection with HIV is common, and concurrent treatment of tuberculosis and HIV is now the standard of care. To ensure that combinations of anti-tuberculosis drugs and antiretrovirals are safe and are tested at doses most likely to be effective, selected pharmacokinetic studies based on knowledge of their metabolic pathways and their capacity to induce or inhibit metabolizing enzymes of companion drugs must be conducted. Drug interaction studies should be followed up by evaluations in larger populations to evaluate safety and pharmacodynamics more fully. Involving patients with HIV in trials of TB drugs early in development enhances the knowledge gained from the trials and will ensure that promising new tuberculosis treatments are available to patients with HIV as early as possible. In this review, we summarize current and planned pharmacokinetic and drug interaction studies involving investigational and licensed tuberculosis drugs and antiretrovirals and suggest priorities for tuberculosis-HIV pharmacokinetic, pharmacodynamic, and drug-drug interaction studies for the future. Priority studies for children and pregnant women with HIV and tuberculosis co-infection are briefly discussed.
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