Pre-exposure prophylaxis to intensify the fight against HIV.

www.thelancet.com/infection Vol 14 June 2014 443 recommendations. Because this was a phase 2 trial that was not powered for comparison of regimens, a phase 3 trial is needed to compare the two doses of raltegravir in patients co-infected with HIV and tuberculosis. In the interim, despite fi ndings from the pharmacokinetic study in healthy volunteers showing a reduction in raltegravir trough concentrations with rifampicin, the results of Grinsztejn and colleagues’ study are the best clinical outcome data available and lend support to the use of standard doses of raltegravir when given with rifampicin, pending a larger phase 3 trial. In this trial, the investigators assessed the use of raltegravir with tuberculosis treatment in fi rst-line ART, and the fi ndings might not be applicable to patients on second-line and third-line regimens, in which the importance of raltegravir concentrations in the regimen might diff er.