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Successful Bosentan and Nonnucleoside Reverse Transcriptase Inhibitor‐Based Therapy in a Patient with Acquired Immunodeficiency Syndrome and Pulmonary Arterial Hypertension
Author(s) -
Hardy Helene,
Backman Elke S.,
Farber Harrison W.
Publication year - 2010
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.30.4.422
Subject(s) - bosentan , nevirapine , reverse transcriptase inhibitor , medicine , regimen , reverse transcriptase , endothelin receptor antagonist , pharmacology , pulmonary hypertension , virology , endothelin receptor , viral load , human immunodeficiency virus (hiv) , biology , antiretroviral therapy , receptor , gene , rna , biochemistry
Pulmonary arterial hypertension (PAH), which can be a complication of human immunodeficiency virus (HIV) infection, is characterized by increased pulmonary arterial pressure and peripheral vascular resistance, subsequently leading to right heart failure. In HIV‐infected patients, the management of PAH is challenging given the potential drug interactions between PAH‐specific vasodilators and antiretroviral drugs. We describe a 51–year‐old female with acquired immunodeficiency syndrome (AIDS) and HIV‐associated PAH. She was treated with the oral endothelin receptor antagonist bosentan while taking a nevirapine (a nonnucleoside reverse transcriptase inhibitor)‐based antiretroviral regimen. Due to concerns about potential drug interactions with the antiretroviral therapy, her nevirapine plasma concentration, as well as CD4 + cell count and viral load, were continuously monitored. We observed no interaction between bosentan and nevirapine during a 4–year period. To our knowledge, this report is the first to demonstrate successful, long‐term coadministration of bosentan and a nonnucleoside reverse transcriptase inhibitor.