"Malabsorption of Antituberculosis Medications by a Patient With AIDS"

Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

"Malabsorption of Antituberculosis Medications by a Patient With AIDS"

New England Journal of Medicine (12/17/92) Vol. 327, No. 25, P. 1819
Berning, Shaun E. et al.

Abstract: Although it could appear that an HIV-positive patient has a drug-resistant strain of tuberculosis, it actually means that the patient has not been absorbing medications properly, write Shaun E. Berning et al. of the National Jewish Center for Immunology and Respiratory Medicine, in Denver, Colo. An HIV-positive male health-care worker from New York City was recently referred to the National Jewish Center for Immunology and Respiratory Medicine. The patient received isoniazid, rifampin, pyrazinamide, and ethambutol from May 1991 to April 1991, with defervescence and weight gain. But in April 1992 fevers, lymphadenopathy, and weight loss developed. The patient underwent biopsy of a supraclavicular node; the specimen was later positive for M. tuberculosis on smear and culture. The patient was found to have an eight-year history of three to five loose stools per day, without gross diarrhea. This result was consistent with a malabsorptive disorder. Capreomycin and clofazimine were added to the drug regimen. These concentrations suggested clinically important malabsorption of the medications. The assays were repeated to confirm the results. The results of the culture of the auxiliary-node biopsy specimen obtained in April 1992 revealed resistance only to isoniazid and streptomycin. The dosages were adjusted, and the patient was discharged with instructions to take rifampin, pyrazinamide, and ethambutol. The researchers conclude that the patient had a recrudescence of TB due to malabsorption of his medications, not to recently acquired drug resistance.

921217
AD922511

Copyright © 1992 - Information, Inc., Bethesda, MD. The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted below for full texts of the articles.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Boehringer Ingelheim, Bridgestone/Firestone Charitable Trust, Elton John AIDS Foundation, the National Library of Medicine, AIDS Walk of Orange County, and donations from users like you.

Always watch for outdated information. This article first appeared in 1992. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 1992. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content.