Article ; Online: Individualized Protease Inhibitor Monotherapy: The Role of Pharmacokinetics and Pharmacogenetics in an Aged and Heavily Treated HIV-Infected Patient.
2019 Volume 39, Issue 11, Page(s) 1125–1131
Abstract: Antiretroviral therapy has changed the history of HIV infection from a lethal disease to a chronic infection, with the emergence of long-term adverse effects. Herein we present a case of a heavily treated HIV-infected man in whom antiretroviral toxicity ... ...
Abstract | Antiretroviral therapy has changed the history of HIV infection from a lethal disease to a chronic infection, with the emergence of long-term adverse effects. Herein we present a case of a heavily treated HIV-infected man in whom antiretroviral toxicity had been observed. The lopinavir/ritonavir plasma concentrations at standard doses were significantly above the recommended levels. Pharmacogenetic analysis revealed a polymorphism in the DRD3 gene associated with a decrease in the rate of drug metabolism. Additionally, the patient's low body mass index could have contributed to a greater degree of patient exposure to the drug. After the withdrawal of tenofovir disoproxil and the establishment of individualized protease inhibitor monotherapy at reduced doses, a decrease in the intensity of adverse events was observed, while the clinical outcomes were maintained. The pharmacokinetic-pharmacogenetic analysis was shown to be a tool of huge interest for the management and durability of antiretroviral therapy. |
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MeSH term(s) | Age Factors ; Drug Substitution/methods ; HIV Infections/drug therapy ; HIV Infections/genetics ; HIV Infections/metabolism ; HIV Protease Inhibitors/adverse effects ; HIV Protease Inhibitors/pharmacokinetics ; HIV-1/drug effects ; HIV-1/genetics ; Humans ; Male ; Middle Aged ; Pharmacogenetics/methods ; Precision Medicine/methods ; Treatment Outcome |
Chemical Substances | HIV Protease Inhibitors |
Language | English |
Publishing date | 2019-08-07 |
Publishing country | New Zealand |
Document type | Case Reports ; Journal Article |
ZDB-ID | 1220136-4 |
ISSN | 1179-1918 ; 0114-2402 ; 1173-2563 |
ISSN (online) | 1179-1918 |
ISSN | 0114-2402 ; 1173-2563 |
DOI | 10.1007/s40261-019-00829-x |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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