Researchers in the School of Pharmacy
http://hdl.handle.net/10566/2044
2024-03-28T12:02:36ZDo HIV infection and antiretroviral therapy influence multidrug-resistant tuberculosis treatment outcomes?
http://hdl.handle.net/10566/2297
Do HIV infection and antiretroviral therapy influence multidrug-resistant tuberculosis treatment outcomes?
Mugabo, Pierre; Adewumi, A.O.; Theron, Danie; Burger, Andries; Van, Zyl L.
The aim of this study was to find out whether human immunodeficiency virus (HIV)-infection and antiretroviral drugs influence multidrug-resistant (MDR)-tuberculosis (TB) treatment outcomes. The study compares MDR-TB treatment outcomes between HIV-positive and HIV-negative patients. It involved patients admitted for treatment of MDR-TB between 1 January 2004 and 31 December 2006. From 363 patients selected, 268 (177 males and 91 females) had MDR-TB and 95 patients (59 males and 36 females) were co-infected with HIV. Children in the HIV-negative group were 41 and 7 in the HIV-positive group. The HIV-infection was treated with Stavudine, Lamivudine and Efavirenz in 54 patients. Kanamycin, Ethionamide, Ofloxacin, Terizidone, Pyrazinamide and Ethambutol were used for MDR-TB treatment. In HIV-negative and HIV-positive patients MDR-TB treatment outcomes were, respectively as follows: 37 and 35% cure, 9 and 5% treatment failure, 20 and 25% lost to follow up, 11 and 17% mortality, 19 and 13% treatment completed, 6 and 5% transfer-out. The cure rate was 100% in children. In HIV-positive patients, MDR-TB cure rate was 35% in patients on ARVs and 34% in patients not receiving ARVs. The difference between these cure rates is not statistically significant (p-value = 0.79). The median (range) duration of ART before the start of MDR-TB treatment was 10.5 (1 to 60) months and did not influence MDR-TB treatment outcomes. In children, the full treatment was supervised in hospital. This could explain the 100% cure rate. Adults' treatment was supervised in hospital only during the intensive phase then followed up as out patients over 18 months. According to the results of this study, HIV-infection and antiretroviral therapy did not influence MDR-TB treatment outcomes.
2015-01-01T00:00:00ZAcute pharmacokinetics of first line anti-tuberculosis drugs in patients with Pulmonary Tuberculosis and in patients with Pulmonary Tuberculosis co-infected with HIV
http://hdl.handle.net/10566/2049
Acute pharmacokinetics of first line anti-tuberculosis drugs in patients with Pulmonary Tuberculosis and in patients with Pulmonary Tuberculosis co-infected with HIV
Mugabo, Pierre; Hassan, Mogamat Shafick; Slaughter, R.
The aim of this study was to compare the pharmacokinetics of antituberculosis drugs in patients with
pulmonary tuberculosis (PTB) and in patients with PTB and HIV during the first 24 h of treatment. Designed as a case-control
study, it compares the pharmacokinetics of first line antituberculous drugs, in HIV-positive (cases) and HIV-negative (control) patients
both presenting with pulmonary tuberculosis. Blood samples were collected before and 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 4.5, 8, 12 and 24 h
after administration of drugs. Drugs plasma levels were tested using HPLC assays. Results: Fourteen HIV positive (7 males and 7
females) and 17 HIV negative (9 males and 8 females) enrolled. Rifafour, a combination tablet including rifampicin, isoniazid,
pyrazinamide and ethambutol was used in HIV positive patients, CD4 counts were significantly lower, renal function mildly decreased
in 85% patients and moderately decreased in 7% patients. Liver function was normal in both groups. None of these patients was on
other drug therapy. In the HIV positive group isoniazid T1/2 and AUC were decreased and Cl increased whereas Tmax and Cmax were
unchanged. Pyrazinamide Tmax and Cmax were significantly decreased in HIV positive patients and no significant changes were
noticed in the T1/2, AUC and CL. Conclusion: The study suggest that ethambutol, pyrazinamide and rifampicin pharmacokinetics was
not affected by HIV infection and that isoniazid disposition is affected by HIV.
2011-01-01T00:00:00ZPotential beneficial effects of Tulbaghia violacea William Henry Harvey (Alliaceae) on cardiovascular system - A review
http://hdl.handle.net/10566/2048
Potential beneficial effects of Tulbaghia violacea William Henry Harvey (Alliaceae) on cardiovascular system - A review
Ismaila, Raji; Kenechukwu, Obikeze; Mugabo, Pierre
Tulbaghia violacea William Henry Harvey (Harv. Alliaceae) is a small bulbous herb belonging to the
family Alliaceae. It is used in South Africa to treat fever, colds, asthma, paralysis, and hypertension.
Meanwhile, cardiovascular disease accounts for about 30 % of total global death, with most of these
deaths occurring in low and middle-income countries. Furthermore, people in low-income countries are
still largely dependent on plants in their surroundings for both prophylaxis and treatment of diseases,
partly due to limited access to and cost of pharmaceuticals, and folkloric evidence of the potency of
medicinal plants and/or local belief systems. Therefore, the present review aims to proffer possible ways
by which T. violacea may improve cardiovascular outcomes. An extensive and systematic review of the
literature was carried out, and relevant findings presented in this review. There is evidence that T.
violacea may modulate the renin-angiotensin system, the autonomic nervous system, oxidative stress
and haemostasis, with resultant protection of the cardiovascular system in both health and disease.
2015-01-01T00:00:00ZDetermination of kanamycin plasma levels using LC-MS and its pharmacokinetics in patients with multidrug-resistant tuberculosis with and without HIV-infection
http://hdl.handle.net/10566/1527
Determination of kanamycin plasma levels using LC-MS and its pharmacokinetics in patients with multidrug-resistant tuberculosis with and without HIV-infection
Mugabo, Pierre; Abaniwonda, Mercy, I.; Theron, Danie; Hassan, Shafick, M.; Stander, Marietjie; Van Zyl, Leonie; McIlleron, Helen; Madsen, Richard
The objectives of the study were: (1) to determine kanamycin plasma concentrations using liquid
chromatography coupled with mass spectrometry (LC-MS), (2) to investigate kanamycin pharmacokinetics (PK) in
patients with multi-drug resistant tuberculosis (MDR-TB), (3) to find out whether HIV infection, kidney dysfunction and
antiretroviral drugs influence kanamycin PK.
The study was designed as a non-randomized study involving male and female HIV- positive and HIVnegative
patients admitted for MDR-TB treatment. Blood samples were collected before (baseline) and ½, 1, 2, 4, 8 and
24 hours after intramuscular injection of kanamycin. LC-MS was used to quantify kanamycin plasma concentrations.
Thirty one patients including 13 HIV (+) participated in the study. The lower limit of detection and lower
limit of quantification of kanamycin were 0.06 μg/ml and 0.15 μg/ml respectively. Kanamycin PK parameters were
described and there was no significant difference between HIV-positive and HIV-negative patients. A statistical significant
difference (p=0.0126) was found in the renal function in HIV - positive and HIV - negative patients. However, this
difference did not affect kanamycin elimination. No interactions have been identified between antiretroviral drugs and
kanamycin. Conclusion: LC-MS analysis method is highly specific and highly sensitive in the detection and quantification
of kanamycin plasma concentrations. Kanamycin PK in patients with MDR-TB was described. Due to a limited number
of patients, we cannot rule out any influence of HIV - infection, renal impairment and antiretroviral drugs on kanamycin
pharmacokinetics. The relationship between the area under the curve of kanamycin free plasma concentrations (fAUC)
and its minimum inhibitory concentrations (MIC) on M.tuberculosis isolated from the sputum of each patient should be
assessed. Therefore, kanamycin free plasma concentrations and MIC should be determined.
2015-01-01T00:00:00Z