{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T17:49:47Z","timestamp":1762624187036,"version":"3.37.3"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,5,29]],"date-time":"2019-05-29T00:00:00Z","timestamp":1559088000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000016","name":"US Department of Health and Human Services","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["U51HA02522"],"award-info":[{"award-number":["U51HA02522"]}],"id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["PS 001058"],"award-info":[{"award-number":["PS 001058"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K23AI125122"],"award-info":[{"award-number":["K23AI125122"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>TB is the leading cause of death among HIV-infected children, yet treatment options for those who require PI-based ART are suboptimal. Rifabutin is the preferred rifamycin for adults on PI-based ART; only one study has evaluated its use among children on PIs and two of six children developed treatment-limiting neutropenia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Since 2009, rifabutin has been available for HIV\/TB-coinfected children requiring PI-based ART in the Harvard\/APIN programme in Nigeria. We retrospectively analysed laboratory and clinical toxicities at baseline and during rifabutin therapy, and examined HIV\/TB outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Between 2009 and 2015, 48 children received rifabutin-containing TB therapy with PI (lopinavir\/ritonavir)-based ART: 50% were female with a median (IQR) baseline age of 1.7 (0.9\u20135.0) years and a median (IQR) CD4+ cell percentage of 15% (9%\u201325%); 52% were ART experienced. Eighty-five percent completed the 6\u2009month rifabutin course with resolution of TB symptoms and 79% were retained in care at 12\u2009months. Adverse events (grade 1\u20134) were more common at baseline (27%) than during rifabutin treatment (15%) (P\u205f=\u205f0.006). Absolute neutrophil count was lower during rifabutin compared with baseline (median\u205f=\u205f1762 versus 2976\u2009cells\/mm3, respectively), but only one instance (2%) of grade 3 neutropenia occurred during rifabutin treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>With clinical and laboratory monitoring, our data suggest that rifabutin is a safe option for TB therapy among children on PI-based ART. By contrast with the only other study of this combination in children, severe neutropenia was rare. Furthermore, outcomes from this cohort suggest that rifabutin is effective, and a novel option for children who require PI-based ART. Additional study of rifabutin plus PIs in children is urgently needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkz219","type":"journal-article","created":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T13:43:36Z","timestamp":1557236616000},"page":"2707-2715","source":"Crossref","is-referenced-by-count":8,"title":["Safety and efficacy of rifabutin among HIV\/TB-coinfected children on lopinavir\/ritonavir-based ART"],"prefix":"10.1093","volume":"74","author":[{"given":"Holly E","family":"Rawizza","sequence":"first","affiliation":[{"name":"Brigham and Women\u2019s Hospital, Boston, MA, USA"},{"name":"Harvard T.H. Chan School of Public Health, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristin M","family":"Darin","sequence":"additional","affiliation":[{"name":"Northwestern University School of Professional Studies, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Regina","family":"Oladokun","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biobele","family":"Brown","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Babatunde","family":"Ogunbosi","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nkiruka","family":"David","sequence":"additional","affiliation":[{"name":"Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sulaimon","family":"Akanmu","sequence":"additional","affiliation":[{"name":"University of Lagos, Lagos State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oluremi","family":"Olaitan","sequence":"additional","affiliation":[{"name":"APIN Public Health Initiatives, Abuja, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"Chang","sequence":"additional","affiliation":[{"name":"Harvard T.H. 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