Marked increase in etravirine and saquinavir plasma concentrations during atovaquone/proguanil prophylaxis

Abstract The case of a 32-year-old Caucasian female with multi-drug resistant HIV-1 subtype B infection treated with a salvage regimen including maraviroc, raltegravir, etravirine and unboosted saquinavir who started atovaquone/proguanil prophylaxis, is reported. The potential interactions between a...

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Bibliographic Details
Published in:Malaria Journal
Main Authors: Ivanovic Jelena, Gallo Anna L, D'Avolio Antonio, Tempestilli Massimo, Bellagamba Rita, Tommasi Chiara, Nicastri Emanuele, Pucillo Leopoldo P, Narciso Pasquale
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2011
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Online Access:https://doi.org/10.1186/1475-2875-10-141
https://doaj.org/article/47b7319a229a46cb9715fb3ee102ddcb
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Summary:Abstract The case of a 32-year-old Caucasian female with multi-drug resistant HIV-1 subtype B infection treated with a salvage regimen including maraviroc, raltegravir, etravirine and unboosted saquinavir who started atovaquone/proguanil prophylaxis, is reported. The potential interactions between atovaquone/proguanil and these anti-retroviral drugs are investigated. Pharmacokinetic analyses documented a marked increase in etravirine and saquinavir plasma concentrations (+55% and +274%, respectively), but not in raltegravir and maraviroc plasma concentrations. The evidence that atovaquone/proguanil significantly interacts with etravirine and saquinavir, but not with raltegravir and maraviroc, suggests that the mechanism of interaction is related to cytochrome P450.