Rifabutin with lopinavir/ritonavir in patients coinfected with tuberculosis and HIV in Burkina Faso

Rifamycin (Rifampicin or Rifabutin) is the principal molecule of conventional TB treatment regimens, including people living with HIV co-infected by TB, but the clinical management of cases of tuberculosis and HIV co-infection is made difficult by several factors, including the important drug interactions between the rifamycins (rifampin and rifabutin) and antiretroviral drugs of the class of protease inhibitors (PI).The basis of the interaction lies in the induction by rifamycins of liver microsomal cytochrome P450-related in particular to its CYP3A4 isoform through which is the hepatic metabolism of IP which, overall, decreased blood concentrations. For this reason, rifampicin can not be used in association with IP, and rifabutin, which has a much more modest inducing effect, is the anti-tuberculosis drug of choice in this clinical situation.This clinical study aims to determine the pharmacokinetics parameters of RFB in combination with Lopinavir/ritonavir in Burkinabe HIV infected patients with tuberculosis, in order, to define optimal doses that will be further tested in a larger phase III trial comparing safety, tolerability and efficacy of RBT and RMP regimens in West Africa.