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. 1996 Dec;72(6):419–421. doi: 10.1136/sti.72.6.419

Uveitis associated with rifabutin and macrolide therapy for Mycobacterium avium intracellulare infection in AIDS patients.

P Kelleher 1, M Helbert 1, J Sweeney 1, J Anderson 1, J Parkin 1, A Pinching 1
PMCID: PMC1195729  PMID: 9038637

Abstract

OBJECTIVE: Uveitis has been increasingly recognised as a side effect of rifabutin regimens in the prophylaxis and treatment of Mycobacterium avium intracellulare (MAI) infection. This study describes the clinical features and analyses the factors associated with rifabutin induced uveitis. DESIGN: Retrospective observational study. SETTING: Tertiary care institution, The Royal Hospitals NHS Trust, London. PATIENTS: 68 HIV seropositive individuals receiving rifabutin for prophylaxis or treatment of MAI infection. RESULTS: 11 episodes of uveitis occurred in 10 different individuals at a median of 62 days. The disease was bilateral in four and unilateral in the remainder. All subjects experienced ocular pain and photophobia and 9 individuals had a significant reduction in visual acuity. Uveitis was treated with mydriatics and topical steroids and resolved in all cases when rifabutin was stopped. The risk of uveitis was significantly increased with concurrent clarithromycin therapy, Odds Ratio 13.08, 95% Confidence Interval 1.98 to 83.12. CONCLUSION: Rifabutin can cause a reversible uveitis. This risk is increased with concurrent clarithromycin therapy. Adverse drug interactions can be an important cause of morbidity in patients with advanced HIV disease.

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Selected References

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  1. Chin D. P., Reingold A. L., Stone E. N., Vittinghoff E., Horsburgh C. R., Jr, Simon E. M., Yajko D. M., Hadley W. K., Ostroff S. M., Hopewell P. C. The impact of Mycobacterium avium complex bacteremia and its treatment on survival of AIDS patients--a prospective study. J Infect Dis. 1994 Sep;170(3):578–584. doi: 10.1093/infdis/170.3.578. [DOI] [PubMed] [Google Scholar]
  2. Farrell P. L., Heinemann M. H., Roberts C. W., Polsky B., Gold J. W., Mamelok A. Response of human immunodeficiency virus-associated uveitis to zidovudine. Am J Ophthalmol. 1988 Jul 15;106(1):7–10. doi: 10.1016/s0002-9394(14)76379-2. [DOI] [PubMed] [Google Scholar]
  3. Frank M. O., Graham M. B., Wispelway B. Rifabutin and uveitis. N Engl J Med. 1994 Mar 24;330(12):868–868. doi: 10.1056/NEJM199403243301218. [DOI] [PubMed] [Google Scholar]
  4. Fuller J. D., Stanfield L. E., Craven D. E. Rifabutin prophylaxis and uveitis. N Engl J Med. 1994 May 5;330(18):1315–1316. doi: 10.1056/NEJM199405053301816. [DOI] [PubMed] [Google Scholar]
  5. Havlir D., Torriani F., Dubé M. Uveitis associated with rifabutin prophylaxis. Ann Intern Med. 1994 Oct 1;121(7):510–512. doi: 10.7326/0003-4819-121-7-199410010-00006. [DOI] [PubMed] [Google Scholar]
  6. Helbert M., Robinson D., Buchanan D., Hellyer T., McCarthy M., Brown I., Pinching A. J., Mitchell D. M. Mycobacterial infection in patients infected with the human immunodeficiency virus. Thorax. 1990 Jan;45(1):45–48. doi: 10.1136/thx.45.1.45. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Lane H. C., Laughon B. E., Falloon J., Kovacs J. A., Davey R. T., Jr, Polis M. A., Masur H. NIH conference. Recent advances in the management of AIDS-related opportunistic infections. Ann Intern Med. 1994 Jun 1;120(11):945–955. doi: 10.7326/0003-4819-120-11-199406010-00007. [DOI] [PubMed] [Google Scholar]
  8. Passo M. S., Rosenbaum J. T. Ocular syphilis in patients with human immunodeficiency virus infection. Am J Ophthalmol. 1988 Jul 15;106(1):1–6. doi: 10.1016/s0002-9394(14)76378-0. [DOI] [PubMed] [Google Scholar]
  9. Saran B. R., Maguire A. M., Nichols C., Frank I., Hertle R. W., Brucker A. J., Goldman S., Brown M., Van Uitert B. Hypopyon uveitis in patients with acquired immunodeficiency syndrome treated for systemic Mycobacterium avium complex infection with rifabutin. Arch Ophthalmol. 1994 Sep;112(9):1159–1165. doi: 10.1001/archopht.1994.01090210043015. [DOI] [PubMed] [Google Scholar]
  10. Shafran S. D., Deschênes J., Miller M., Phillips P., Toma E. Uveitis and pseudojaundice during a regimen of clarithromycin, rifabutin, and ethambutol. MAC Study Group of the Canadian HIV Trials Network. N Engl J Med. 1994 Feb 10;330(6):438–439. doi: 10.1056/NEJM199402103300616. [DOI] [PubMed] [Google Scholar]
  11. Siegal F. P., Eilbott D., Burger H., Gehan K., Davidson B., Kaell A. T., Weiser B. Dose-limiting toxicity of rifabutin in AIDS-related complex: syndrome of arthralgia/arthritis. AIDS. 1990 May;4(5):433–441. doi: 10.1097/00002030-199005000-00009. [DOI] [PubMed] [Google Scholar]

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