(ATDN) Eye Problems and Rifabutin


(ATDN) Eye Problems and Rifabutin

Treatment Review No. 11; April 1994

If you are experiencing any changes in vision you should see an ophthalmologist who is knowledgeable about HIV-related conditions. One of the conditions that may change your eyesight is uveitis. Uveitis is inflammation of the uvea, which includes the iris - the colored part of the eye. Symptoms of this condition include eye pain, light sensitivity, redness and blurred vision. In severe cases blindness can result, although it is often reversible. It is important not to confuse the symptoms of uveitis with early signs of CMV retinitis, another eye disorder caused by a herpes virus.

Rifabutin, or Mycobutin, is used for the treatment of mycobacterium avium complex (MAC). MAC is an opportunistic infection associated with AIDS. Rifabutin is also being studied for the prevention of MAC. Twelve cases of the eye disorder called uveitis have been reported in individuals participating in a MAC prevention study sponsored by the NIH. The side effects are believed to be associated with rifabutin. Rifabutin may also be associated with increased arthritis pain in the joints.

Of the twelve cases of uveitis reported, two have been rated "severe," while the others are "mild" or "moderate." Drug interactions may also be responsible for the side effect. Taking rifabutin at the same time as clarithromycin, another drug used for MAC treatment, could cause the problem. Earlier studies have also shown that taking fluconazole, a treatment for fungal infections, at the same time can increase levels of rifabutin in the blood by up to 80%. Increased levels of drug in the blood may lead to greater risk for side effects.

The Informed Consent Form for the study ACTG 196/CPCRA 009, a clinical trial for MAC prevention, did not mention uveitis as a possible side effect. It has since been changed to alert doctors and trial participants to the possibility of this side effect. A letter was sent out to all doctors involved in the study by Adria Pharmaceuticals, the maker of the drug Rifabutin. The symptoms of MAC are worse and more dangerous than uveitis. As drugs are used for longer periods of time and by more people, symptoms or conditions that weren't seen before can occur. If you are taking rifabutin or are in ACTG 196/CPCRA 009, you should be aware of any changes in your eyes or any increases in arthritic pain in your joints and report them to your doctor.


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This information is designed to support, not replace, the relationship that exists between you and your doctor.
©1994. AEGIS.