Open AccessCase Report of Increased Exposure to Antiretrovirals following Sleeve Gastrectomy
Author(s) -
Sarah Israel,
Hila Elinav,
Ram Elazary,
Daniel Porat,
Roni Gibori,
Arik Dahan,
Carmil Azran,
Ehud Horwitz
Publication year - 2020
Publication title -
antimicrobial agents and chemotherapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.07
H-Index - 259
eISSN - 1070-6283
pISSN - 0066-4804
DOI - 10.1128/aac.02453-19
Subject(s) - abacavir , sleeve gastrectomy , dolutegravir , medicine , lamivudine , antiretroviral drug , morbidly obese , surgery , gastrectomy , human immunodeficiency virus (hiv) , drug , obesity , weight loss , antiretroviral therapy , viral load , pharmacology , virology , gastric bypass , virus , cancer , hepatitis b virus
Bariatric surgery is increasingly performed in morbidly obese HIV patients. Limited data exist regarding antiretroviral drug exposure after bariatric surgery. We report a case of a morbidly obese HIV patient who underwent sleeve gastrectomy. Abacavir, lamivudine, and dolutegravir therapeutic drug monitoring was performed at several time points pre- and postsurgery. Significantly increased levels were measured, particularly for abacavir, whose levels increased ∼12-fold. Several mechanistic explanations for these findings are discussed.