Dose-limiting toxicity of rifabutin in AIDS-related complex: Syndrome of arthralgia/arthritis

Frederick P. Siegal, David Eilbott, Harold Burger, Kevin Gehan, Bruce Davidson, Alan T. Kaell, Barbara Weiser

Research output: Contribution to journalArticlepeer-review

80 Scopus citations


We studied the tolerance of humans to rifabutin, a rifamycin with antimycobacterial and in vitro anti-HIV activity. Sixteen subjects with AIDS-related complex were treated for 4-66 weeks with stepwise increasing oral doses of rifabutin from 300 to 2400 mg/day. The highest dose attained was twice that previously reported for humans. Serum and cerebrospinal fluid levels of drug were detected by high-pressure liquid chromatography. A reversible syndrome of arthritis/arthralgia, not previously described, was seen in most (nine out of 10) of those given doses exceeding 1050 mg/day. Uveitis and aphthous stomatitis developed at doses of approximately 1800 mg in two of those with joint manifestations. Typical manifestations of Reiter's syndrome were not seen in any patient. An orange-tan skin pigmentation was almost universal. Other toxicities resembled those previously associated with rifampin. Serum levels did not approach those found to inhibit HIV significantly in vitro. No consistent antiviral or immunological effects were observed; even at the highest doses, rifabutin did not appear to inhibit cellular immunity. Rifabutin was well tolerated at daily doses blow 1 g.

Original languageEnglish (US)
Pages (from-to)433-441
Number of pages9
Issue number5
StatePublished - May 1990
Externally publishedYes


  • AIDS-related complex
  • Ansamycin
  • Antiviral
  • Arthralgia
  • Arthritis
  • HIV
  • Immune function
  • Mycobacteria
  • Pharmacokinetics
  • Rifabutin
  • Toxicity
  • Uveitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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