Dolutegravir use in combination with rifampicin-based tuberculosis therapy: 3 years of real-world experience in a large UK teaching hospital

Dolutegravir is a substrate of UGT1A1 and CYP3A4, both of which are induced by rifampicin.1 Coadministration with rifampicin results in decreases in dolutegravir plasma exposure, requiring doubling of the daily dose of dolutegravir.1 Preliminary results of a phase III study (INSPIRING) evaluating the safety of dolutegravir use (50 mg twice daily) in combination with rifampicin were recently presented at the Conference on Retroviruses and Opportunistic Infections.2 At 24 weeks, 81% (56/69) of HIV/TB coinfected individuals receiving dolutegravir were shown to have achieved HIV-1 RNA <50 copies/mL. We present a real-world experience of using dolutegravir in combination with rifampicin.

A case note review of all HIV/tuberculosis (TB) coinfected individuals was conducted between January 2015 and March 2018. Descriptive statistics were performed to examine the demographics, laboratory results and treatments.

A total of 10 individuals were identified who were on dolutegravir-containing antiretroviral therapy (ART) while being treated for TB with rifampicin-based therapy….

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