Abstract:
AIM:To investigate the pharmacokinetics of voriconazole when administered to HIV-positive patients receiving treatment with atazanavir-containing therapies according to CYP2C19 genotype. MATERIALS & METHODS:We describe four HIV-positive patients with pulmonary aspergillosis treated with voriconazole and atazanavir-based regimens (with or without ritonavir). They were managed by assessing their CYP2C19 genotype (CYP2C19*2, rs4244285, G>A, real-time PCR) and therapeutic drug monitoring (HPLC-based validation methods). RESULTS & CONCLUSION:Voriconazole exposure was variable but Ctrough levels were above 1000 ng/ml in all patients; one CYP2C19 intermediate metabolizer required lower doses of voriconazole (50 mg twice daily) to obtain satisfactory drug concentrations. Atazanavir and ritonavir plasma levels were moderately reduced (area under the curve: -23 and -26%, respectively); raltegravir exposure seemed increased by voriconazole administration (area under the curve: 2.5-fold higher) in a single subject. Coadministration of atazanavir and voriconazole may be feasible in selected HIV-positive patients; therapeutic drug monitoring and CYP2C19 genotyping may optimize exposure of both drugs.
journal_name
Pharmacogenomicsjournal_title
Pharmacogenomicsauthors
Calcagno A,Baietto L,Pagani N,Simiele M,Audagnotto S,D'Avolio A,De Rosa FG,Di Perri G,Bonora Sdoi
10.2217/pgs.14.92subject
Has Abstractpub_date
2014-07-01 00:00:00pages
1281-6issue
10eissn
1462-2416issn
1744-8042journal_volume
15pub_type
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