Journal Article

Antiretroviral Drug Pharmacokinetics in Hepatitis with Hepatic Dysfunction

David L. Wyles and John G. Gerber

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 40, issue 1, pages 174-181
Published in print January 2005 | ISSN: 1058-4838
Published online January 2005 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/426021
Antiretroviral Drug Pharmacokinetics in Hepatitis with Hepatic Dysfunction

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Chronic viral hepatitis is common among persons with HIV-1 infection, because of shared modes of transmission, and coinfection results in accelerated liver damage, compared with persons with chronic viral hepatitis alone. The use of highly active antiretroviral therapy (HAART) has led to a significant decrease in the morbidity and mortality associated with HIV-1 infection. A number of the medications that are commonly used in HAART regimens are metabolized by the hepatic CYP enzymes, which raises the possibility of significant interactions between antiretroviral medications and hepatic impairment induced by chronic viral hepatitis. Although the data are still very scant, the pharmacokinetics of several antiretroviral medications have been shown to be significantly altered in the presence of liver disease. In the present report, we review the available data and consider potential options, such as dose adjustment and therapeutic drug monitoring, for the administration of antiretroviral therapy to patients with significant hepatic impairment.

Journal Article.  5919 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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