dc.contributor.author |
Bolland, Mark |
en |
dc.contributor.author |
Grey, Andrew |
en |
dc.contributor.author |
Horne, Anne |
en |
dc.contributor.author |
Thomas, Mark |
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dc.date.accessioned |
2008-09-25T03:05:16Z |
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dc.date.available |
2008-09-25T03:05:16Z |
en |
dc.date.issued |
2008 |
en |
dc.identifier.citation |
Annals of Clinical Microbiology and Antimicrobials 7(1), 3. 2008 |
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dc.identifier.issn |
1476-0711 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/3032 |
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dc.description |
An open access copy of this article is available and complies with the copyright holder/publisher conditions. |
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dc.description.abstract |
INTRODUCTION: People infected with human immunodeficiency virus are frequently treated with medications that can induce or inhibit cytochrome P450 enzymes.CASE PRESENTATION:A 59 year old man treated with zidovudine, lamivudine, indinavir, and ritonavir for infection with human immunodeficiency virus volunteered to take part in a study of bone loss. He was found to have vitamin D insufficiency with secondary hyperparathyroidism and received vitamin D and calcium supplementation. He suffered a recurrence of infection with Mycobacterium avium intracellulare for which he received treatment with ciprofloxacin, rifabutin, and ethambutol. Subsequently, he developed worsening vitamin D deficiency with hypocalcaemia, secondary hyperparathyroidism and elevated markers of bone turnover culminating in an osteomalacic vertebral fracture. Correction of the vitamin D deficiency required 100,000 IU of cholecalciferol monthly.Rifabutin is a cytochrome P450 inducer, and vitamin D and its metabolites are catabolised by cytochrome P450 enzymes. We therefore propose that treatment with rifabutin led to the induction of cytochrome P450 enzymes catabolising vitamin D, thereby causing vitamin D deficiency and osteomalacia. This process might be mediated through the steroid and xenobiotic receptor (SXR).CONCLUSION:Treatment with rifabutin induces the cytochrome P450 enzymes that metabolise vitamin D and patients treated with rifabutin might be at increased risk of vitamin D deficiency. In complex medication regimens involving agents that induce or inhibit cytochrome P450 enzmyes, consultation with a clinical pharmacist or pharmacologist may be helpful in predicting and/or preventing potentially harmful interactions. |
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dc.publisher |
BioMed Central Ltd. |
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dc.relation.ispartofseries |
Annals of Clinical Microbiology and Antimicrobials |
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dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from http://www.sherpa.ac.uk/romeo/issn/1476-0711/ |
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dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.rights.uri |
http://creativecommons.org/licenses/by/3.0/ |
en |
dc.source.uri |
http://dx.doi.org/10.1186/1476-0711-7-3 |
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dc.title |
Osteomalacia in an HIV-infected man receiving rifabutin, a cytochrome P450 enzyme inducer: a case report |
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dc.type |
Journal Article |
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dc.subject.marsden |
Fields of Research::320000 Medical and Health Sciences |
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dc.identifier.doi |
10.1186/1476-0711-7-3 |
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pubs.issue |
1 |
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pubs.begin-page |
3 |
en |
pubs.volume |
7 |
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dc.description.version |
VoR - Version of Record |
en |
dc.rights.holder |
Copyright: Bolland et al; licensee BioMed Central Ltd. |
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dc.rights.accessrights |
http://purl.org/eprint/accessRights/OpenAccess |
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