TY - JOUR
T1 - Factors associated with altered pharmacokinetics in substance users and non-substance users receiving lopinavir and atazanavir
AU - Higgins, Niamh
AU - Zingman, Barry S.
AU - Slish, Judianne
AU - Reichman, Richard C.
AU - Fischl, Margaret A.
AU - Gripshover, Barbara
AU - Tooley, Kelly
AU - Boston, Naomi
AU - Forrest, Alan
AU - Brazeau, Dan
AU - Catanzaro, Linda M.
AU - DiFrancesco, Robin
AU - Lliguicota, Francesco
AU - Ma, Qing
AU - Morse, Gene D.
PY - 2007/11
Y1 - 2007/11
N2 - Substance use is highly prevalent in HIV-infected individuals in the United States, and clinical management is complicated by the need for antiretroviral treatment, addiction therapy, variable medication adherence, and co-morbidities. The interrelation between HIV and substance use prompted our investigation to examine substance use and self-reported medication adherence in patients receiving the HIV-1 protease inhibitors, atazanavir (ATV) or lopinavir (LPV). ATV and LPV pharmacokinetics were determined by measuring plasma concentrations in subjects with active substance use (SU group) or with no active substance use (NSU group). No difference in adherence was observed between groups (p > 0.05). The mean SU ATV trough was 0.550±0.45 μg/mL; the mean NSU ATV trough was 0.780±0.590 μg/mL (p > 0.05). The mean SU LPV trough was 4.02±2.39 μg/mL; the mean NSU LPV trough was 6.67±0.910 μg/mL (p = 0.01). Co-factors found to be associated with variation in ATV and LPV concentrations included concurrent methadone use, cigarette smoking, and substance use status. These data indicate that chronic HIV treatment may be assisted with plasma concentration monitoring to identify those patients who may require dosage modification and/or regimen adjustment in order to optimize antiretroviral effects.
AB - Substance use is highly prevalent in HIV-infected individuals in the United States, and clinical management is complicated by the need for antiretroviral treatment, addiction therapy, variable medication adherence, and co-morbidities. The interrelation between HIV and substance use prompted our investigation to examine substance use and self-reported medication adherence in patients receiving the HIV-1 protease inhibitors, atazanavir (ATV) or lopinavir (LPV). ATV and LPV pharmacokinetics were determined by measuring plasma concentrations in subjects with active substance use (SU group) or with no active substance use (NSU group). No difference in adherence was observed between groups (p > 0.05). The mean SU ATV trough was 0.550±0.45 μg/mL; the mean NSU ATV trough was 0.780±0.590 μg/mL (p > 0.05). The mean SU LPV trough was 4.02±2.39 μg/mL; the mean NSU LPV trough was 6.67±0.910 μg/mL (p = 0.01). Co-factors found to be associated with variation in ATV and LPV concentrations included concurrent methadone use, cigarette smoking, and substance use status. These data indicate that chronic HIV treatment may be assisted with plasma concentration monitoring to identify those patients who may require dosage modification and/or regimen adjustment in order to optimize antiretroviral effects.
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U2 - 10.1080/10550490701641256
DO - 10.1080/10550490701641256
M3 - Article
C2 - 18058416
AN - SCOPUS:33947601056
SN - 1055-0496
VL - 16
SP - 488
EP - 494
JO - American Journal on Addictions
JF - American Journal on Addictions
IS - 6
ER -