Antiretroviral and Immunosuppressive Drug-Drug Interactions in Human Immunodeficiency Virus-Infected Liver and Kidney Transplant Recipients

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Highly active antiretroviral therapy (HAART) has significantly reduced mortality, and prolonged life expectancy of human immunodeficiency virus (HIV)-positive patients. Such improvements have led to increasing numbers of HIV-infected patients with end-stage organ disease as potential candidates for transplantation. A HAART regimen usually consists of a combination of nucleoside reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRTI), and/or protease inhibitors (PI). PI are known to strongly inhibit the cytochrome P450 3A (CYP3A) enzyme system that is responsible for the metabolism of immunosuppressive drugs, such as tacrolimus, sirolimus, and cyclosporine. Besides these pharmacokinetic drug-drug interactions, potential pharmacodynamic drug-drug interactions may also occur with concomitant HAART and antimetabolites, such as mycophenolate mofetil. An approach to immunosuppressive management in HIV-infected organ transplant recipients requires attention to such complexities as unique drug-drug interactions and increased drug-related toxicities.

Original languageEnglish (US)
Pages (from-to)3796-3799
Number of pages4
JournalTransplantation Proceedings
Volume41
Issue number9
DOIs
StatePublished - Nov 2009

Fingerprint

Immunosuppressive Agents
Drug Interactions
Highly Active Antiretroviral Therapy
HIV
Kidney
Reverse Transcriptase Inhibitors
Liver
Protease Inhibitors
Pharmaceutical Preparations
Mycophenolic Acid
Antimetabolites
Cytochrome P-450 CYP3A
Tacrolimus
Sirolimus
Life Expectancy
Drug-Related Side Effects and Adverse Reactions
Nucleosides
Cytochrome P-450 Enzyme System
Cyclosporine
Pharmacokinetics

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

@article{0c17ba301aaf43cba46592faa02be9a9,
title = "Antiretroviral and Immunosuppressive Drug-Drug Interactions in Human Immunodeficiency Virus-Infected Liver and Kidney Transplant Recipients",
abstract = "Highly active antiretroviral therapy (HAART) has significantly reduced mortality, and prolonged life expectancy of human immunodeficiency virus (HIV)-positive patients. Such improvements have led to increasing numbers of HIV-infected patients with end-stage organ disease as potential candidates for transplantation. A HAART regimen usually consists of a combination of nucleoside reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRTI), and/or protease inhibitors (PI). PI are known to strongly inhibit the cytochrome P450 3A (CYP3A) enzyme system that is responsible for the metabolism of immunosuppressive drugs, such as tacrolimus, sirolimus, and cyclosporine. Besides these pharmacokinetic drug-drug interactions, potential pharmacodynamic drug-drug interactions may also occur with concomitant HAART and antimetabolites, such as mycophenolate mofetil. An approach to immunosuppressive management in HIV-infected organ transplant recipients requires attention to such complexities as unique drug-drug interactions and increased drug-related toxicities.",
author = "K. Marfo and Greenstein, {Stuart M.}",
year = "2009",
month = "11",
doi = "10.1016/j.transproceed.2009.06.186",
language = "English (US)",
volume = "41",
pages = "3796--3799",
journal = "Transplantation Proceedings",
issn = "0041-1345",
publisher = "Elsevier USA",
number = "9",

}

TY - JOUR

T1 - Antiretroviral and Immunosuppressive Drug-Drug Interactions in Human Immunodeficiency Virus-Infected Liver and Kidney Transplant Recipients

AU - Marfo, K.

AU - Greenstein, Stuart M.

PY - 2009/11

Y1 - 2009/11

N2 - Highly active antiretroviral therapy (HAART) has significantly reduced mortality, and prolonged life expectancy of human immunodeficiency virus (HIV)-positive patients. Such improvements have led to increasing numbers of HIV-infected patients with end-stage organ disease as potential candidates for transplantation. A HAART regimen usually consists of a combination of nucleoside reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRTI), and/or protease inhibitors (PI). PI are known to strongly inhibit the cytochrome P450 3A (CYP3A) enzyme system that is responsible for the metabolism of immunosuppressive drugs, such as tacrolimus, sirolimus, and cyclosporine. Besides these pharmacokinetic drug-drug interactions, potential pharmacodynamic drug-drug interactions may also occur with concomitant HAART and antimetabolites, such as mycophenolate mofetil. An approach to immunosuppressive management in HIV-infected organ transplant recipients requires attention to such complexities as unique drug-drug interactions and increased drug-related toxicities.

AB - Highly active antiretroviral therapy (HAART) has significantly reduced mortality, and prolonged life expectancy of human immunodeficiency virus (HIV)-positive patients. Such improvements have led to increasing numbers of HIV-infected patients with end-stage organ disease as potential candidates for transplantation. A HAART regimen usually consists of a combination of nucleoside reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRTI), and/or protease inhibitors (PI). PI are known to strongly inhibit the cytochrome P450 3A (CYP3A) enzyme system that is responsible for the metabolism of immunosuppressive drugs, such as tacrolimus, sirolimus, and cyclosporine. Besides these pharmacokinetic drug-drug interactions, potential pharmacodynamic drug-drug interactions may also occur with concomitant HAART and antimetabolites, such as mycophenolate mofetil. An approach to immunosuppressive management in HIV-infected organ transplant recipients requires attention to such complexities as unique drug-drug interactions and increased drug-related toxicities.

UR - http://www.scopus.com/inward/record.url?scp=71749116885&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=71749116885&partnerID=8YFLogxK

U2 - 10.1016/j.transproceed.2009.06.186

DO - 10.1016/j.transproceed.2009.06.186

M3 - Article

VL - 41

SP - 3796

EP - 3799

JO - Transplantation Proceedings

JF - Transplantation Proceedings

SN - 0041-1345

IS - 9

ER -