{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:13:40Z","timestamp":1788315220496,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>HIV co\u2010infection affects host responses and pharmacokinetics (PK) of tuberculosis (TB) treatment. This study assessed the PK of first\u2010line anti\u2010TB drugs and clinical outcomes in patients with and without HIV co\u2010infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective observational study, 61 adults with sputum\u2010positive pulmonary TB, either confirmed by microscopy or GeneXpert, were enrolled, including 24 with HIV co\u2010infection and 37 without. All HIV\u2010positive participants were antiretroviral\u2010na\u00efve at enrolment. Standard anti\u2010TB therapy was given, and PK assessments were conducted on Day 1 and Week 6. Efavirenz\u2010based antiretroviral therapy (ART) began at a median of Day 21. Clinical outcomes, sputum conversion, and adverse events were monitored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, patients with HIV co\u2010infection had reduced clearance of isoniazid and ethambutol, reflected by slower elimination rates. These differences resolved by Week 6 and were not significantly impacted by ART initiation. Logistic regression showed that HIV\u2010positive status (OR\u2009=\u200914.25, 95% CI: 1.22\u2013166.37,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), and higher baseline sputum bacillary load (OR\u2009=\u20093.92, 95% CI: 1.5\u201310.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006) were independently associated with delayed sputum conversion beyond 8\u2009weeks. Baseline CRP showed an inverse association after adjustment, but this did not reach statistical significance (OR\u2009=\u20090.98, 95% CI: 0.96\u20131.00,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.06).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HIV co\u2010infection was associated with altered early PK of isoniazid and ethambutol although these differences were less apparent by Week 6. HIV\u2010positive status and higher baseline sputum bacillary load were associated with delayed sputum conversion. Although some pharmacokinetic differences were statistically significant, their clinical relevance remains uncertain, and the current data do not support dose adjustment. These findings suggest early pharmacokinetic variability in TB\u2013HIV co\u2010infected patients and support further investigation in adequately powered exposure\u2013response studies.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      : NCT02457208\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.70165","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T01:31:41Z","timestamp":1779240701000},"page":"1261-1272","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Altered Pharmacokinetics and Delayed Sputum Conversion in Tuberculosis Patients Co\u2010Infected With\n                    <scp>HIV<\/scp>"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0383-9624","authenticated-orcid":false,"given":"Aung Pyae","family":"Phyo","sequence":"first","affiliation":[{"name":"Mahidol\u2010Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Shoklo Malaria Research Unit Mahidol University  Mae Ramat Tak Thailand"},{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard M.","family":"Hoglund","sequence":"additional","affiliation":[{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine University of Oxford  Oxford UK"},{"name":"Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Saito","sequence":"additional","affiliation":[{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine University of Oxford  Oxford UK"},{"name":"Division of Infectious Diseases University of Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sein Sein","family":"Thi","sequence":"additional","affiliation":[{"name":"Mahidol\u2010Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Shoklo Malaria Research Unit Mahidol University  Mae Ramat Tak Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei Lei","family":"Swe","sequence":"additional","affiliation":[{"name":"Mahidol\u2010Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Shoklo Malaria Research Unit Mahidol University  Mae Ramat Tak 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Maung","family":"Maung","sequence":"additional","affiliation":[{"name":"Mahidol\u2010Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Shoklo Malaria Research Unit Mahidol University  Mae Ramat Tak Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanapat","family":"Pateekham","sequence":"additional","affiliation":[{"name":"Mahidol\u2010Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Shoklo Malaria Research Unit Mahidol University  Mae Ramat Tak Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanitda","family":"Watthanaworawit","sequence":"additional","affiliation":[{"name":"Mahidol\u2010Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Shoklo Malaria Research Unit Mahidol University  Mae Ramat Tak Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gornpan","family":"Gornsawun","sequence":"additional","affiliation":[{"name":"Mahidol\u2010Oxford 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