Clinical Pharmacology of TB and HIV Therapeutics
Title: Associate Professor
Department: Medicine; Division of Infectious Diseases and Global Medicine
Research Interests: Pharmacokinetics and pharmacogenetics of HIV and TB therapy, HIV comorbidities such as tuberculosis and hepatitis B virus, general infectious diseases and global health
Dr. Kwara is an Infectious Diseases Specialist with training in public health and tropical medicine. He obtained his MbChB from the University of Ghana Medical School in 1992. He completed Internal Medicine Residency at Cook County Hospital and an Infectious Disease Fellowship at Tulane University Health Sciences Center, both in the United States. He has broad expertise in the following areas: global health, infectious diseases, and HIV and tuberculosis coinfection research.
Dr. Kwara’s research focuses on clinical pharmacology of antiretroviral and antituberculosis therapy in patients with HIV and tuberculosis coinfection. He is the Principal Investigator of an National Institutes of Health grant that seeks to investigate the pharmacokinetics, drug-drug interactions and pharmacogenetics of HIV and TB treatment in children in Ghana. The treatment of TB and HIV often requires the co-administration of seven or more different drugs. Individual differences in drug metabolism, drug-drug, as well as drug-gene interactions may lead to ineffective therapy due to low drug concentrations or toxicities due to high drug concentrations of some of the drugs. Without such direct pharmacokinetic data, rational decisions about prescribing TB and HIV medications in children are not possible.
His work with key collaborators in the United States and Ghana seeks to unravel the molecular basis of inter-individual variability in TB and HIV drugs pharmacokinetics, and drug-drug interactions in individuals with HIV and TB coinfection. His work has resulted in a series of publications that have validated known (CYP2B6) and identified novel (CYP2A6 and UGT2B7) pharmacogenomic biomarkers of efavirenz, as well as identified the novel association between UGT2B7 polymorphisms and zidovudine disposition in HIV/TB co-infected Ghanaian patients. He has also identified a potential mechanism explaining why some individuals paradoxically develop higher, rather than the expected lower, concentrations of efavirenz during rifampin-containing TB therapy.
Dr. Kwara collaborates with colleagues at the Center for Pharmacogenenomics in the Department of Pharmacotherapy and Translation Research at UF College of Pharmacy. Their research will characterize the genetic determinants of antiretroviral drug response including virologic outcome and long-term toxicities. Beyond the field of HIV therapeutics, it is anticipated that this research will inform how pharmacogenomics information can be used to minimize adverse drug reactions and optimize treatment outcomes at the individual and population levels.