nevirapine-based antiretroviral therapy impacts artesunate and dihydroartemisinin disposition in hiv-infected nigerian adults

nevirapine-based antiretroviral therapy impacts artesunate and dihydroartemisinin disposition in hiv-infected nigerian adults

;Fatai A. Fehintola;Kimberly K. Scarsi;Qing Ma;Sunil Parikh;Gene D. Morse;Babafemi Taiwo;Ibrahim Tope Akinola;Isaac F. Adewole;Niklas Lindegardh;Aphiradee Phakderaj;Oladosu Ojengbede;Robert L. Murphy;Olusegun O. Akinyinka;Francesca T. Aweeka
brachytherapy 2012 Vol. 2012 pp. -
228
fehintola2012aidsnevirapine-based

Abstract

Background. Nevirapine- (NVP-) based antiretroviral therapy (ART) and artesunate-amodiaquine are frequently coprescribed in areas of HIV and malaria endemicity. We explored the impact of this practice on artesunate and dihydroartemisinin pharmacokinetics. Methods. We conducted a parallel-group pharmacokinetic comparison between HIV-infected patients receiving NVP-based ART (n=10) and ART-naive controls (n=11). Artesunate-amodiaquine 200/600 mg was given daily for three days. Measurement of drug concentrations occurred between 0 and 96 hours after the final dose. Pharmacokinetic parameters were determined using noncompartmental analysis. Results. Comparing the NVP group to controls, clearance of artesunate was reduced 50% (1950 versus 2995 L/h; P=0.03), resulting in a 45% increase in the AUC0-96 (105 versus 69 ug∗hr/L; P=0.02). The half-life of dihydroartemisinin was shorter in the NVP group (1.6 versuss 3.2 h; P=0.004), but other dihydroartemisinin pharmacokinetic parameters were unchanged. A lower conversion of artesunate to dihydroartemisinin was observed in the NVP group (dihydroartemisinin: artesunate AUC0-96=5.6 versuss 8.5 in NVP and control groups, respectively, P=0.008). Conclusion. Although NVP-containing ART impacted some pharmacokinetic parameters of artesunate and dihydroartemisinin, overall exposure was similar or better in the NVP group.

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147788
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10.1155/2012/703604
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