Browsing by Author "Ibrahim Tope Akinola"

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    Nevirapine-based antiretroviral therapy impacts artesunate and dihydroartemisinin disposition in HIV-infected Nigerian adults
    (2012-12-01) 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
    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.