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Introduction Indinavir (IDV) is a potent HIV protease inhibitor used in the treatment of human immunodeficiency virus (HIV). IDV is a weak base with limited aqueous solubility in its unprotonated form; therefore, solubility of IDV in the gastrointestinal tract fluids is the rate-limiting step of its absorption and onset of action. However, in many cases, drugs are not absorbed well in the gastrointestinal tract; polymer nanoparticles were recognized as an effective carrier system for drug encapsulation and are now studied as a vehicle for oral delivery of insoluble compounds. Preparation of methoxy poly (ethylene glycol)-poly (e-caprolactone) (mPEG-PCL) nanoparticles is among the strategies to overcome low bioavailability of drugs with poor aqueous solubility.Materials and method The structure of the copolymers was characterized using 1H NMR, FTIR, DSC and GPC techniques. IDV loaded mPEG- PCL nanoparticles prepared by emulsification solvent evaporation method were optimized using D-optimal experimental design and were characterized by various techniques such as DLS, DSC, XRD, AFM and SEM. Using Caco-2 cells as a cellular model, we studied the cellular uptake and transport.Results In vivo pharmacokinetic studies were performed in rats. The plasma AUC (0–t), t1/2 and Cmax of IDV-mPEG-PCL NPs were increased by 5.30, 5.57 and 1.37 fold compared to the IDV solution, respectively.Conclusion The results of this study are promising for the use of biodegradable polymeric nanoparticles to improve oral drug delivery.

AimTo describe the pharmacokinetics and safety of indinavir boosted with ritonavir (IDV/r) during the second and third trimesters of pregnancy and in the post-partum period.MethodsIMPAACT P1026s is an on-going, prospective, non-blinded study of antiretroviral pharmacokinetics (PK) in HIV-infected pregnant women with a Thai cohort receiving IDV/r 400/100 mg twice daily during pregnancy through to 6-12 weeks post-partum as part of clinical care. Steady-state PK profiles were performed during the second (optional) and third trimesters and at 6-12 weeks post-partum. PK targets were the estimated 10(th) percentile IDV AUC (12.9 μg ml(-1)h) in non-pregnant historical Thai adults and a trough concentration of 0.1 μg ml(-1), the suggested minimum target.ResultsTwenty-six pregnant women were enrolled; thirteen entered during the second trimester. Median (range) age was 29.8 (18.9-40.8) years and weight 60.5 (50.0-85.0) kg at the third trimester PK visit. The 90% confidence limits for the geometric mean ratio of the indinavir AUC(0,12 h) and Cmax during the second trimester and post-partum (ante : post ratios) were 0.58 (0.49, 0.68) and 0.73 (0.59, 0.91), respectively; third trimester/post-partum AUC(0,12 h) and Cmax ratios were 0.60 (0.53, 0.68) and 0.63 (0.55, 0.72), respectively. IDV/r was well tolerated and 21/26 women had a HIV-1 viral load < 40 copies ml(-1) at delivery. All 26 infants were confirmed HIV negative.ConclusionIndinavir exposure during the second and third trimesters was significantly reduced compared with post-partum and ∼30% of women failed to achieve a target trough concentration. Increasing the dose of IDV/r during pregnancy to 600/100 mg twice daily may be preferable to ensure adequate drug concentrations.

Aiming an alternative short synthesis of the piperazine fragment of Indinavir we developed the following strategy: i) regioselective C-3 ring opening of (S)-tert-butyl-N-p-tosylaziridine-carboxamide by 3-picolylamine; ii) N,N'-bisalkylation with diphenyl vinyl sulfonium triflate; iii) N-detosylation. By this sequence, after only three steps, the (S)-N-tert-butyl-4-(pyridin-3-ylmethyl)piperazine-2-carboxamide was obtained, in 20% overall yield. [ABSTRACT FROM AUTHOR]

This study developed a novel child-friendly drug delivery system for pediatric HIV treatment: a liquid, taste-masked, and solvent-free monoolein-based nanoparticles formulation containing indinavir (0.1%). Adherence to antiretroviral therapy by pediatric patients is difficult because of the lack of dosage forms adequate for children. Monoolein-based nanoparticles were developed. The particle size, zeta potential, pH, drug content, small angle X-ray scattering, stability, in vitro drug release profile, biocompatibility, toxicity, and taste-masking properties were evaluated. Monoolein-based formulations containing indinavir had nanosized particles with 155 ± 7 nm, unimodal particle size distribution, and polydispersity index of 0.16 ± 0.03. The zeta potential was negative (−31.3 ± 0.3 mV) and pH was neutral (7.78 ± 0.01). A 96% drug incorporation efficiency was achieved, and the indinavir concentration remained constant for 30 days. Polarized light microscopy revealed isotropic characteristics. Transmission electron microscopy images showed spherical shaped morphology. Small-angle X-ray scattering displayed a form factor broad peak. Indinavir had a sustained release from the nanoparticles. The system was nonirritant and was able to mask drug bitter taste. Monoolein-based nanoparticles represent a suitable therapeutic strategy for antiretroviral treatment with the potential to reduce the frequency of drug administration and promote pediatric adherence. [ABSTRACT FROM AUTHOR]

Background: Increased pericardial adipose tissue is associated with higher risk of cardiovascular disease. We aimed to determine whether human immunodeficiency virus (HIV) status was independently associated with larger pericardial adipose tissue volume and to explore possible HIV-specific risk factors.Methods: Persons with HIV (PWH) were recruited from the Copenhagen Comorbidity in HIV Infection (COCOMO) Study and matched 1:1 on age and sex to uninfected controls. Pericardial adipose tissue volume was measured using cardiac computed tomography.Results: A total of 587 PWH and 587 controls were included. Median age was 52 years, and 88% were male. Human immunodeficiency virus status was independently associated with 17 mL (95% confidence interval [CI], 10-23; P < .001) larger pericardial adipose tissue volume. Larger pericardial adipose tissue volume was associated with low CD4+ nadir and prior use of stavudine, didanosine, and indinavir. Among PWH without thymidine analogue or didanosine exposure, time since initiating combination antiretroviral treatment (per 5-year use) was associated with l6 mL (95% CI, -6 to -25; P = .002) lower pericardial adipose tissue volume.Conclusions: Human immunodeficiency virus status was independently associated with larger pericardial adipose tissue volume. Severe immunodeficiency, stavudine, didanosine, and indinavir were associated with larger pericardial adipose tissue volume. Persons with HIV with prior exposure to these drugs may constitute a distinct cardiovascular risk population. [ABSTRACT FROM AUTHOR]

Indinavir (IDV) is a potent and well-tolerated protease inhibitor antiretroviral (ARV) drug used as a component of the highly active antiretroviral therapy (HAART) of human immunodeficiency virus (HIV). It undergoes hepatic first-pass metabolism that is catalysed by microsomal cytochrome P450-3A4 enzyme (CYP3A4), which results in pharmacokinetics that may be favourable or adverse. Therapeutic drug monitoring (TDM) of IDV during HIV treatment is therefore critical, in order to prevent the adverse effects of its first-pass metabolism and optimise an individual's dosage regime. Biosensors are now the preferred diagnostic tools for TDM assessment at point-of-care, due to their high sensitivity and real-time response. An electrochemical biosensor for IDV was prepared by depositing a thin film of CYP3A4 (a thiolate enzyme) and thioglycolic acid-capped palladium telluride quantum dot (TGA-PdTeQD) on a cysteamine-functionalised gold disk electrode (Cyst|Au) using a combination of thiol and carbodiimide covalent bonding chemistries. The electrochemical signatures of the biosensor (CYP3A4|TGA-PdTeQD|Cyst|Au) were determined by cyclic voltammetry (CV) that was performed at a scan rate of 500 mV s−1, and the sensor responses at the characteristic reduction peak potential value of − 0.26 V were recorded. The sensitivity, linear range (LR) and limit of detection (LOD) values of the indinavir biosensor were 4.45 ± 0.11 μA nM−1 IDV, 0.5–1.0 nM IDV (i.e. 3.6 × 10−4–7.1 × 10−4 mg L−1 IDV) and 4.5 × 10−4 mg L−1 IDV, respectively. The values of the two analytical parameters (LR and LOD) of the biosensor were by up to four orders of magnitude lower than the maximum plasma concentration (Cmax) values of indinavir (0.13–8.6 mg L−1 IDV). The IDV biosensor was successfully used to detect IDV in human serum samples containing dissolved indinavir tablet. This, therefore, indicates the indinavir biosensor's suitability for TDM applications, using samples obtained within 1–2 h of drug intake at point-of-care, for which very low levels of the drug are expected. [ABSTRACT FROM AUTHOR]

Introduction: Indinavir (IDV) is a potent HIV protease inhibitor used in the treatment of human immunodeficiency virus (HIV). IDV is a weak base with limited aqueous solubility in its unprotonated form; therefore, solubility of IDV in the gastrointestinal tract fluids is the rate-limiting step of its absorption and onset of action. However, in many cases, drugs are not absorbed well in the gastrointestinal tract; polymer nanoparticles were recognized as an effective carrier system for drug encapsulation and are now studied as a vehicle for oral delivery of insoluble compounds. Preparation of methoxy poly (ethylene glycol)-poly (e-caprolactone) (mPEG-PCL) nanoparticles is among the strategies to overcome low bioavailability of drugs with poor aqueous solubility. Materials and method: The structure of the copolymers was characterized using 1H NMR, FTIR, DSC and GPC techniques. IDV loaded mPEG- PCL nanoparticles prepared by emulsification solvent evaporation method were optimized using D-optimal experimental design and were characterized by various techniques such as DLS, DSC, XRD, AFM and SEM. Using Caco-2 cells as a cellular model, we studied the cellular uptake and transport. Results:In vivo pharmacokinetic studies were performed in rats. The plasma AUC (0–t), t1/2 and Cmax of IDV-mPEG-PCL NPs were increased by 5.30, 5.57 and 1.37 fold compared to the IDV solution, respectively. Conclusion: The results of this study are promising for the use of biodegradable polymeric nanoparticles to improve oral drug delivery. [ABSTRACT FROM AUTHOR]