Pharmacokinetics of rifabutin in HIV-infected patients with or without wasting syndrome

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Aims. The purpose of the study was to compare the pharmacokinetic parameters of rifabutin obtained in a group of patients without wasting syndrome (NWS) with those obtained in a group with wasting syndrome (WS). Methods. A single dose of 300 mg rifabutin was administered in the fasting state to the patients in both study groups and blood samples were scheduled to be collected at the following times: 0 (predose), 0.5, 1, 2, 3, 4, 6, 8, 24, 48, 72 and 96 h following administration. Data were analysed using noncompartmental methods. The pharmacokinetic parameters of rifabutin in patients with and without wasting syndrome were compared using the Mann-Whitney U-test. Results. C(max) was 0.34 ± 0.14 mg l-1 in NWS patients and 0.55 ± 0.16 mg l-1 (P = 0.01) in patients with WS. t(max) was 4.2 ± 1.5 and 3.3 ± 2.3 h (P = 0.17) in NWS and WS patients, respectively. The AUCs were similar in the two study groups. V/F was 2905 ± 16461 in NWS patients and 1701 ± 4921 (P = 0.07) for the WS group. These differences are less pronounced following normalization of V/F to patients body weight (43.7 ± 20.1 vs 35.4 ± 10.3 1 kg-1). t(1/2,λz) tended to be shorter in patients with WS (31.4 ± 12.9 vs 46.0 ± 23.5 h, P = 0.12). Conclusions. Our study suggests that the pharmacokinetics of rifabutin in patients with wasting syndrome are not altered to a degree that is clinically important.

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