Lopinavir/ritonavir in patients with human immunodeficiency virus infection in special situations
Copyright © 2014 Elsevier España, S.L.U. All rights reserved..
Ritonavir-boosted lopinavir (LPV/r) is a protease inhibitor used for the treatment of human immunodeficiency virus (HIV) infection in both normal patients and in certain situations. In patients with renal failure, LPV/r does not require dosage adjustment because it is metabolized in the liver. Cohort studies have shown that the incidence of varying degrees of renal disease and/or crystalluria related to combination antiretroviral therapy with tenofovir and some protease inhibitors (PI) does not appear with LPV/r or that the incidence is much lower with this combination. Neurocognitive impairments are described in a high proportion of patients with HIV infection and viral replication or related inflammatory activity in the subarachnoid space. In these patients, LPV/r is one of the therapeutic options. A score has been published that rates antiretroviral drugs according to the concentration attained in the cerebrospinal fluid (CSF). LPV/r levels reached in CSF exceed the IC50 of wild-type HIV and has a valuable score (score 3) of the drugs currently used. The most important comorbid condition is chronic hepatitis, due to its frequency and because the biotransformation of LPV/r occurs in the liver. In these circumstances, it is important to evaluate the influence of liver failure on blood drug levels and how these values may cause liver toxicity. LPV/r dose modification has not been established in the presence of liver failure. LPV/r-induced liver toxicity has only been reported with a certain frequency when liver enzymes were elevated at baseline or in patients with chronic hepatitis C, although most cases of liver toxicity were mild.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2014 |
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| Erschienen: |
2014 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:32 Suppl 3 |
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| Enthalten in: |
Enfermedades infecciosas y microbiologia clinica - 32 Suppl 3(2014) vom: 15. Nov., Seite 18-21 |
| Sprache: |
Spanisch |
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| Weiterer Titel: |
Lopinavir/ritonavir en pacientes infectados por el virus de la inmunodeficiencia humana en situaciones especiales |
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| Beteiligte Personen: |
Tasias, María [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 31.10.2016 Date Revised 03.01.2017 published: Print Citation Status MEDLINE |
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| doi: |
10.1016/S0213-005X(14)70163-6 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM244907188 |
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| 520 | |a Copyright © 2014 Elsevier España, S.L.U. All rights reserved. | ||
| 520 | |a Ritonavir-boosted lopinavir (LPV/r) is a protease inhibitor used for the treatment of human immunodeficiency virus (HIV) infection in both normal patients and in certain situations. In patients with renal failure, LPV/r does not require dosage adjustment because it is metabolized in the liver. Cohort studies have shown that the incidence of varying degrees of renal disease and/or crystalluria related to combination antiretroviral therapy with tenofovir and some protease inhibitors (PI) does not appear with LPV/r or that the incidence is much lower with this combination. Neurocognitive impairments are described in a high proportion of patients with HIV infection and viral replication or related inflammatory activity in the subarachnoid space. In these patients, LPV/r is one of the therapeutic options. A score has been published that rates antiretroviral drugs according to the concentration attained in the cerebrospinal fluid (CSF). LPV/r levels reached in CSF exceed the IC50 of wild-type HIV and has a valuable score (score 3) of the drugs currently used. The most important comorbid condition is chronic hepatitis, due to its frequency and because the biotransformation of LPV/r occurs in the liver. In these circumstances, it is important to evaluate the influence of liver failure on blood drug levels and how these values may cause liver toxicity. LPV/r dose modification has not been established in the presence of liver failure. LPV/r-induced liver toxicity has only been reported with a certain frequency when liver enzymes were elevated at baseline or in patients with chronic hepatitis C, although most cases of liver toxicity were mild | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Alteraciones neurocognitivas | |
| 650 | 4 | |a Coinfección con virus de la hepatitis C | |
| 650 | 4 | |a HIV-1 | |
| 650 | 4 | |a HIV-2 | |
| 650 | 4 | |a Hepatitis C virus co-infection | |
| 650 | 4 | |a Inhibidores de la proteasa | |
| 650 | 4 | |a Insuficiencia renal | |
| 650 | 4 | |a Lopinavir | |
| 650 | 4 | |a Neurocognitive impairment | |
| 650 | 4 | |a Protease inhibitors | |
| 650 | 4 | |a Renal failure | |
| 650 | 4 | |a Ritonavir | |
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