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Title: Nevirapine-based antiretroviral therapy impacts artesunate and dihydroartemisinin disposition in HIV-infected Nigerian adults
Authors: 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
University of Ibadan
Northwestern University Feinberg School of Medicine
University at Buffalo, State University of New York
University of California, San Francisco
University College Hospital, Ibadan
Mahidol University
Keywords: Medicine
Issue Date: 1-Dec-2012
Citation: AIDS Research and Treatment. Vol.2012, (2012)
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 AUC(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 AUC=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. © 2012 Fatai A. Fehintola et al.
ISSN: 20901259
Appears in Collections:Scopus 2011-2015

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