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Abstract
Pharmacokinetic of protease inhibitors based regimens in 6 liver transplantation HIV-infected patients
M. Tavio1, U. Baccarani2, A. Londero1, F. Pea3, F. Pavan3, M. Crapis1, C. Negri1, I. Garlatti1, D. Papais1, M. Buttus1, G. Adani2, D. Lorenzin2, F. Bresadola2, P. Viale1
Background: Protease inhibitors (PIs) have been described as inhibitors of metabolism of immunosuppressive drugs cyclosporine (CsA) and tacrolimus (FK), rising concerns about the management of combination immunosuppressive (IST) and antiretroviral therapy (ART) in HIV patients (pts) undergoing liver transplantation (OLTx).
Methods: from 11/04 to 02/06 six HIV pts (1 female, 5 males) underwent OLTx for end stage liver disease (ESLD). Table 1 shows pts characteristics at OLTx listing.
| Nr | Age | Risk | ESLD | Meld | Child | AIDS | VL | CD4 | ART | | 1 | 40 | IVDU | HCV | 13 | B7 | Yes | < 50 | > 200 | TDF-3TC-NFV | | 2 | 40 | IVDU | HCV | 16 | C10 | No | 400 | > 200 | NO | | 3 | 46 | IVDU | HCC-HCV | 24 | A5 | No | < 50 | > 200 | TDF-d4T-LPV/r | | 4 | 53 | Unsafe sex | HCC | 24 | B7 | No | < 50 | > 200 | TDF-3TC-APV | | 5 | 40 | Partner HIV+ | ROW | 12 | B7 | No | < 50 | > 200 | TDF-DDI-NFV | | 6 | 48 | IVDU | HCC-HCV | 24 | B7 | No | 983 | > 200 | NO |
Legenda: HCC: hepatocarcinoma; ROW: Rendu-Osler-Weber syndrome; TDF: tenofovir; 3TC: lamivudina; NFV: nelfinavir; APV: amprenavir; d4t: stavudine; LPV/r: lopinavir/ritonavir; DDI: didanosine.
The ART after OLTx was the same for all patients: TDF-3TC -NFV.
CsA, FK and NFV plasma levels were scheduled to optimize the drug dosage.
Results: Table 2 shows pts characteristics at the last control (02/06).
| Nr | F. U. (ws) | IST | IST (dose) | PI (dose) | Outcome | | 1 | 69 | CsA + P | 100mg/24h | NFV (500 mg/die) | alive | | 2 | 56 | FK + P | 1mg/48h | NFV (1250mg x2/die) | alive | | 3 | 52 | CsA + P | 75mgx 2/die | NFV (1250mg x2/die) | alive | | 4 | 46 | FK + P | 0,5 mg/48h | NFV (1250mg x2/die) | alive | | 5 | 27 | FK + P | 0,5 mg/48h | NFV (1000 mg x2/die) | alive | | 6 | 16 | CsA + P | 75+50mg/24h | NFV (1000 mg x2/die) | alive |
Conclusions: Our data of pt #1, #5 and #6, in which the dose of NFV was adjusted to maintain the recommended C-trough level, underscore the need for routine therapeutic drug monitoring also of PIs to optimize the combination of IST and ART.
AIDS 2006 - XVI International AIDS Conference
Abstract no.
CDB0332
Suggested Citation
"M.Tavio, et al.
Pharmacokinetic of protease inhibitors based regimens in 6 liver transplantation HIV-infected patients.
:
AIDS 2006 - XVI International AIDS Conference:
Abstract no.
CDB0332"
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