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High EFV or RPV concentrations may cause QT prolongation.
• DTG, RAL and RPV have fewer lipid effects.
• TDF has been associated with lower lipid levels than ABC or TAF.
ese regimens have a high genetic barrier to resistance.
TDF, TAF, FTC, and 3TC are active against both HIV and HBV. 3TC- or FTC-
associated HBV mutations can emerge rapidly when these drugs are used without
another drug active against HBV.
• Rifamycins may significantly reduce TAF exposure.
• Rifampin is a strong inducer of CYP3A4 and UGT1A1 enzymes, causing significant
decrease in concentrations of PIs, INSTIs, and RPV.
• Rifampin has a less significant effect on EFV concentration than on other NNRTIs,
PIs, and INSTIs.
• Rifabutin is a less potent inducer and is a good option for patients receiving non-
EFV-based regimens.
Refer to http://aidsinfo.nih.gov/guidelines for dosing recommendations for rifamycins
used with different ARV agents.
Rationale/Comments
