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Factors Associated with Altered Pharmacokinetics in Substance Users and Non‐Substance Users Receiving Lopinavir and Atazanavir
Author(s) -
Higgins Niamh,
Zingman Barry S.,
Slish Judianne,
Reichman Richard C.,
Fischl Margaret A.,
Gripshover Barbara,
Tooley Kelly,
Boston Naomi,
Forrest Alan,
Brazeau Dan,
Catanzaro Linda M.,
DiFrancesco Robin,
Lliguicota Francesco,
Ma Qing,
Morse Gene D.
Publication year - 2007
Publication title -
the american journal on addictions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.997
H-Index - 76
eISSN - 1521-0391
pISSN - 1055-0496
DOI - 10.1080/10550490701641256
Subject(s) - atazanavir , lopinavir , medicine , methadone , pharmacokinetics , substance use , drug , human immunodeficiency virus (hiv) , pharmacology , antiretroviral therapy , viral load , immunology , psychiatry
Substance use is highly prevalent in HIV‐infected individuals in the United States, and clinical management is complicated by the need for antiretroviral treatment, addiction therapy, variable medication adherence, and co‐morbidities. The interrelation between HIV and substance use prompted our investigation to examine substance use and self‐reported medication adherence in patients receiving the HIV‐1 protease inhibitors, atazanavir (ATV) or lopinavir (LPV). ATV and LPV pharmacokinetics were determined by measuring plasma concentrations in subjects with active substance use (SU group) or with no active substance use (NSU group). No difference in adherence was observed between groups (p > 0.05). The mean SU ATV trough was 0.550±0.45 μg/mL; the mean NSU ATV trough was 0.780±0.590 μg/mL (p > 0.05). The mean SU LPV trough was 4.02±2.39 μg/mL; the mean NSU LPV trough was 6.67±0.910 μg/mL (p = 0.01). Co‐factors found to be associated with variation in ATV and LPV concentrations included concurrent methadone use, cigarette smoking, and substance use status. These data indicate that chronic HIV treatment may be assisted with plasma concentration monitoring to identify those patients who may require dosage modification and/or regimen adjustment in order to optimize antiretroviral effects.