ArticleAIDS (London, England)2008
The pharmacokinetics and pharmacogenomics of efavirenz and lopinavir/ritonavir in HIV-infected persons requiring hemodialysis.
Article in AIDS (London, England), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pharmacokinetics/Pharmacodynamics of Antiviral Agents Used to Treat SARS-CoV-2 and Their Potential Interaction with Drugs and Other Supportive Measures: A Comprehensive Review by the PK/PD of Anti-Infectives Study Group of the European Society of Antimicrobial Agents.Clinical pharmacokinetics · 2020Pooled it
- Clinical practice guideline for the management of chronic kidney disease in patients infected with HIV: 2014 update by the HIV Medicine Association of the Infectious Diseases Society of America.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2014Guideline
- The steady-state pharmacokinetics of fixed-dose combination dolutegravir+rilpivirine in hemodialysis.AIDS (London, England) · 2025Article
- Recommendations for Dosing of Repurposed COVID-19 Medications in Patients with Renal and Hepatic Impairment.Drugs in R&D · 2021Review
- Pharmacotherapeutic options for kidney disease in HIV positive patients.Expert opinion on pharmacotherapy · 2021Review
- Antiviral Dosing Modification for Coronavirus Disease 2019-Infected Patients Receiving Extracorporeal Therapy.Critical care explorations · 2020Article
- Concerns about pharmacokinetic (PK) and pharmacokinetic-pharmacodynamic (PK-PD) studies in the new therapeutic area of COVID-19 infection.Antiviral research · 2020Review
- Quadruple therapy for asymptomatic COVID-19 infection patients.Expert review of anti-infective therapy · 2020Article
- Novel Antiretroviral Drugs in Patients with Renal Impairment: Clinical and Pharmacokinetic Considerations.European journal of drug metabolism and pharmacokinetics · 2017Review
- CYP3A4 polymorphism and lopinavir toxicity in an HIV-infected pregnant woman.Clinical drug investigation · 2015Article
- A single-nucleotide polymorphism in CYP2B6 leads to >3-fold increases in efavirenz concentrations in plasma and hair among HIV-infected women.The Journal of infectious diseases · 2012Article
- Management of the kidney transplant patient with chronic hepatitis C infection.International journal of nephrology · 2011Article
- Hemodialysis does not significantly affect the pharmacokinetics of nevirapine in HIV-1-infected persons requiring hemodialysis: results from ACTG A5177.Journal of acquired immune deficiency syndromes (1999) · 2010Article
- COVID-19 Pneumonia in a Hemodialysis Patient.Kidney medicineArticle
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7 authors.
Funding
Abstract
objectiveTo evaluate the pharmacokinetics and pharmacogenomics of efavirenz (EFV) and lopinavir/ritonavir (LPV/RTV) in HIV-infected persons requiring hemodialysis.
designProspective, observational study of HIV-infected hemodialysis patients receiving one 600 mg tablet daily of EFV (N = 13) or three 133.3/33.3 mg capsules twice daily of LPV/RTV (N = 13).
methodsTwenty-four-hour EFV and 12-h LPV/RTV pharmacokinetics were assessed. Geometric mean ratios were calculated using historical controls with normal renal function. The effects of several candidate gene polymorphisms were also explored.
resultsThe geometric mean [95% confidence interval (CI); percentage of coefficient of variation (% CV)] Cmin, Cmax, and area under the curve (AUC) for the EFV group were 1.81 microg/ml (0.93, 3.53; 103%), 5.04 microg/ml (3.48, 7.29; 72%), and 71.5 microg h/ml (43.2, 118.3; 93%), respectively. These parameters were 2.76 microg/ml (1.86, 4.11; 53%), 8.45 microg/ml (6.41, 11.15; 52%), and 69.6 microg h/ml (55.6, 87.2; 37%) for LPV and 0.08 microg/ml (0.05, 0.14; 63%), 0.58 microg/ml (0.44, 0.76; 41%), and 3.74 microg h/ml (2.91, 4.80; 37%) for RTV. The AUC geometric mean ratios (90% CI) for EFV, LPV, and RTV were 132% (89, 197), 81% (67, 97), and 92% (76, 111), respectively. LPV Cmin was lower than expected in the hemodialysis group. Higher EFV concentrations were associated with the CYP2B6 516G>T polymorphism.
conclusionThe pharmacokinetics of EFV and LPV/RTV in hemodialysis suggests that no dosing adjustments are necessary in treatment-naive patients. As HIV-infected hemodialysis patients are disproportionately black, the increased frequency of the CYP2B6 516G>T polymorphism may lead to higher EFV levels. The potentially lower LPV trough levels in this population suggest that LPV/RTV should be used with caution in protease-inhibitor-experienced patients.
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