Potential drug interaction with paclitaxel and highly active antiretroviral therapy in two patients with AIDS-associated Kaposi sarcoma.
Highly active antiretroviral therapy (HAART) consisting of multiple combinations of antiretroviral agents that inhibit HIV (HIV) replication has been associated with improvements in CD4+ T-lymphocyte cell counts, suppression of HIV replication, and regression of HIV-associated Kaposi's sarcoma (KS). Several of these agents have complex drug-drug interactions and have the potential to aggravate paclitaxel-associated toxicities. Herein two patients with KS are described who received paclitaxel while on HAART and who developed life-threatening toxicities. These cases are presented to alert clinicians to potentially serious drug interactions that can occur between various components of HAART and paclitaxel. Clinicians contemplating taxane-based chemotherapy for HIV-associated KS should carefully monitor patients for adverse events and, depending on their patient's HAART regimen, consider reducing the taxane dose.
Bundow
Denise
D
Virginia Mason Medical Center, Seattle, Washington, USA.
Aboulafia
David M
DM
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy; D019380:Anti-HIV Agents / Q000494:pharmacology* / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000494:pharmacology* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D004347:Drug Interactions; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000494:pharmacology* / Q000627:therapeutic use; D012514:Sarcoma, Kaposi / Q000188:drug therapy* / Q000209:etiology
D019380:Anti-HIV Agents; D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel