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The aim of this study was to evaluate efavirenz and nevirapine plasma levels in HIV-infected hemophilic patients seen in two hospitals in Barcelona. Plasma levels of these drugs were determined by high-performance liquid chromatography (HPLC) at four-month intervals, together with viral load and CD4 cell count. Nineteen patients treated with efavirenz and 8 with nevirapine were included, and 68 efavirenz and 31 nevirapine determinations were performed. Mean study time was 12 months. Median efavirenz plasma concentration was 2.95 .g/ml (interval: 1.54-5.26 .g/ml) in patients with favorable virological response and 1.86 .g/ml (0.82-4.88 .g/ml) in patients with detectable viral load (p = 0.32). Nevirapine plasma concentrations were 4.41 .g/ml (3.50-6.72 .g/ml) and 3.12 .g/ml (2.44-3.80 .g/ml) respectively (p = 0.18).

Visceral leishmaniosis was diagnosed in a working sled dog on the basis of history, clinical signs, and identification of amastigotes in a skin biopsy specimen. Allopurinol was administered as sole treatment for the disease. The drug was given for 9 months, and, during this time, clinical signs of disease resolved. Laboratory abnormalities had resolved by 12 months after diagnosis and 3 months after treatment. The dog has been without medications for 19 months and remains free of clinical signs, has sired 2 litters, and functions well as lead sled dog for a team.