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Lopinavir/ritonavir exposure in treatment-naive HIV-infected children following twice or once daily administration.
- Source :
-
The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2006 Jun; Vol. 57 (6), pp. 1168-71. Date of Electronic Publication: 2006 Apr 10. - Publication Year :
- 2006
-
Abstract
- Objectives: Lopinavir/ritonavir is approved for treatment of HIV-infected children at a dosage regimen of 230/57.5 mg/m(2) twice daily. However, once daily administration could increase convenience and patient adherence. Our study aimed at evaluating whether inhibitory concentrations are maintained in plasma following administration of lopinavir/ritonavir once daily.<br />Patients and Methods: Lopinavir/ritonavir was administered at the standard twice daily regimen to 21 HIV-infected children, as a component of their antiretroviral treatment. Following at least 1 month of administration, seven patients received a dose of 460/115 mg/m(2) once daily for three consecutive days. After the third dose of once daily administration, blood samples were drawn at the following times: 0 (pre-dose), 1, 2 and 4 h following administration. The pre-dose (C(min)) and the peak (C(max)) concentrations were compared with the values obtained following twice daily administration in all the study patients.<br />Results: Median (interquartile range) C(min) with the once daily regimen was 1.59 (0.77-6.85) mg/L versus 7.90 (5.45-9.77) mg/L with the twice daily regimen (P < 0.05). C(min) was considered inhibitory for wild-type virus (>1.0 mg/L) in four out of seven patients. C(max) did not differ significantly between the once daily and twice daily regimens.<br />Conclusions: Our small pilot study suggests that lopinavir/ritonavir once daily may be a suitable regimen for antiretroviral-naive children. However, due to the high interindividual variability and low concentrations in some patients, therapeutic drug monitoring may be necessary to ensure that concentrations are adequate to inhibit viral replication. A formal clinical study of lopinavir/ritonavir once daily in treatment-naive children is warranted.
- Subjects :
- Adolescent
Anti-HIV Agents blood
Anti-HIV Agents pharmacokinetics
Anti-HIV Agents therapeutic use
Child
Child, Preschool
Drug Administration Schedule
Drug Monitoring
Drug Therapy, Combination
Female
Humans
Lopinavir
Male
Plasma chemistry
Pyrimidinones blood
Pyrimidinones pharmacokinetics
Pyrimidinones therapeutic use
Ritonavir blood
Ritonavir pharmacokinetics
Ritonavir therapeutic use
Anti-HIV Agents administration & dosage
HIV Infections drug therapy
Pyrimidinones administration & dosage
Ritonavir administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 0305-7453
- Volume :
- 57
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Journal of antimicrobial chemotherapy
- Publication Type :
- Academic Journal
- Accession number :
- 16606636
- Full Text :
- https://doi.org/10.1093/jac/dkl136