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Background This study aimed to assess the pharmacokinetic profile of rifabutin (RBT) given at 150 mg or 300 mg every other day (EOD) in tuberculosis (TB)-HIV co-infected adult patients. Methods This is a pharmacokinetic prospective, pilot, open, randomised study of two doses of RBT in combination with lopinavir/ritonavir among HIV−TB patients in Burkina. Sixteen patients were randomised in two arms: TB treatment consisting HZE standard doses in association with RBT150 mg EOD (arm A, 8 patients) or RBT300 mg EOD (arm B, 8 patients) in combination with lopinavir/ritonavir. RBT plasma concentrations were evaluated after two weeks of combined HIV and TB treatment. Samples were collected at pre-dosing and at 1, 2, 3, 4, 6, 8 and12 hours after drug ingestion to measure plasma drug concentration using HPLC–MS/MS assay. Results The mean Cmax and AUC in the RBT 150 mg arm (Cmax=0.35±0,18 µg/mL, AUC(0–24)=3.94±2,1 µg.h/mL) were significantly lower (p=0.01) than those of the RBT 300 mg arm (Cmax=0.75±0.54 µg/mL AUC(0–24)=7.1±2.7 µg.h/mL). There was no significant difference in Tmax (Tmax=3.44±2.01 hours vs Tmax=3.86±2.04 hours) p=0.687. RBT follows linear kinetics and no significant differences were apparent in the mean oral clearance (CL/F) estimates (p=0.683), which were dose independent and similar for the 2 assessment doses. Five of 8 patients in RBT150 mg arm had a Cmax below plasma therapeutic limit ( 0.06 µg/mL) compared with 4 of 8 patients in the RBT150 mg arm. The means Cmax, AUC (0–24) and Tmax of 25-O-desacetyl rifabutin of the RBT 300 mg arm were increased by 100% and 50% respectively compared to the RBT150 mg arm. Conclusions This study confirmed that the dose of rifabutin 150 mg three times a week in combination with lopinavir/ ritonavir is inadequate and could lead to the selection of rifamycin-resistant mycobacteria.

Background Sexually transmitted infections are widespread globally, especially among people aged 15–25. Chlamydia trachomatis is the most common sexually-acquired bacterial disease. This infection is not notified in Italy; prevalence data on population-based surveys are not available. Methods We conducted a prevalence survey among students aged 18 or older attending high schools in the Province of Brescia, Northern Italy. A total of 3134 adolescents were offered to enter the study; overall, 1886/3134 (60.2%) participated. Each consenting student answered to a socio-behavioural questionnaire and C. trachomatis and N. gonorrhoeae were searched on first void urine samples using VERSANT ® CT/GC DNA 1.0 Assay (kPCR). We present preliminary data concerning 1311 enrolled individuals attending 16 schools. Results Overall, 63.8% (836/1311) were females and the median age was 18.4 years. Most students (91.7%) were born in Italy. 77.1% of the enrolled students declared to be sexually active (F > M, p F, p = 0.017) admitted always using it. Females were found to become sexually active earlier, had more partners in the previous six months and less frequently used condoms. No case of N. gonorrhoeae infection was identified, while 8 males and 13 females were positive for C. trachomatis, with a prevalence rate among sexually active students of 2.4% (IC 95%:1.0–4.8) and 1.9% (IC 95%:1.0–3.3) respectively. The factors significantly associated with an increased risk of Chlamydial infection were the inconsistent condom use (p = 0.029) and a higher number of sexual partners during the previous six months (p = 0.013). Conclusion A lower than expected prevalence of C. trachomatis infection was observed among sexually active adolescents in Northern Italy. Study conducted with scientific and logistic support from Copan S.p.A. and Siemens Healthcare Diagnostic S.p.A.