Plasma concentrations of efavirenz are associated with body weight in HIV-positive individuals
Autor: | Julia Poeta, Jorge Pinto Ribeiro, Lucia Real, Marina Venzon Antunes, Andréia Magalhães de Menezes, Rafael Linden, Eduardo Sprinz |
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Rok vydání: | 2011 |
Předmět: |
Adult
Cyclopropanes Male Microbiology (medical) Aging Efavirenz Anti-HIV Agents Human immunodeficiency virus (HIV) Physiology HIV Infections Pharmacology Body weight medicine.disease_cause chemistry.chemical_compound medicine Humans Pharmacology (medical) Adverse effect Aged medicine.diagnostic_test business.industry Body Weight virus diseases Middle Aged Viral Load Benzoxazines CD4 Lymphocyte Count Infectious Diseases chemistry Therapeutic drug monitoring Alkynes Plasma concentration Cohort HIV-1 Reverse Transcriptase Inhibitors Female Drug Monitoring business Body mass index |
Zdroj: | Journal of Antimicrobial Chemotherapy. 66:2601-2604 |
ISSN: | 1460-2091 0305-7453 |
Popis: | Efavirenz is among the most widely used antiretroviral drugs. Increased efavirenz exposure has been associated with CNS side effects and also with the chance of emergence of resistance upon treatment interruptions. The objective of this study was to evaluate factors associated with efavirenz plasma concentrations in a cohort of HIV-infected individuals.From July 2009 to March 2010, HIV-infected patients with efavirenz as part of antiretroviral therapy (600 mg at night), undetectable viral load for at least 1 year and CD4 cell count200 cells/mm(3) were consecutively enrolled at the HIV/AIDS ambulatory care unit in southern Brazil. Plasma samples were taken 18-23 h after efavirenz last dose and analysed by validated ultra-performance liquid chromatography.Forty-one subjects were included (21 females). Mean age and weight were 45.4 years and 70.9 kg, respectively. Mean efavirenz plasma concentration was 2.20 ± 2.17 mg/L. Most plasma concentrations (73%) were within the therapeutic window (1-4 mg/L); 17% were below and 10% above the limits. There were no significant associations between efavirenz concentration and age, CD4 cell count, time on antiretroviral treatment and gender. There was significant and inverse correlation between efavirenz concentrations and body weight (P = 0.013) and body mass index (P = 0.001).In this cohort of well-controlled HIV-positive individuals, patients with lower weight or body mass index had a higher chance of presenting elevated plasma concentrations of efavirenz. Therapeutic drug monitoring to adjust dose might be a helpful tool to decrease efavirenz dose in order to minimize costs and adverse effects. |
Databáze: | OpenAIRE |
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