title: Oral valganciclovir in children: single dose pharmacokinetics in a six-year-old girl.
abstract: We report a pharmacokinetic study in a 6-year-old girl with congenital human immunodeficiency virus type 1 and cytomegalovirus coinfection maintained on iv ganciclovir for 6 years. Increasing infection and thrombosis caused by her iv device necessitated alternative therapy. Single dose pharmacokinetics of ganciclovir 4.4 mg/kg iv and valganciclovir 13.2 and 26.3 mg/kg po were studied with high performance liquid chromatography/tandem mass spectrometry. The two oral dosages yielded areas under the concentration curve of 14.3 and 28.7 microg x h/ml, equivalent to 43% bioavailability of ganciclovir from valganciclovir, which exceeded the area under the concentration curve of 11.1 microg x h/ml yielded by ganciclovir 4.4 mg/kg iv. Oral valganciclovir achieved therapeutic and dosage-proportional plasma concentrations in the child we studied.
authors.affiliation: University Children's Hospital, Basel, Switzerland.
authors.forename: Marcus
authors.initials: M
authors.lastname: Burri
authors.forename: Hugh
authors.initials: H
authors.lastname: Wiltshire
authors.forename: Christian
authors.initials: C
authors.lastname: Kahlert
authors.forename: George
authors.initials: G
authors.lastname: Wouters
authors.forename: Christoph
authors.initials: C
authors.lastname: Rudin
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000284:Administration, Oral; D000998:Antiviral Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use; D019540:Area Under Curve; D001682:Biological Availability; D002648:Child; D002851:Chromatography, High Pressure Liquid; D003586:Cytomegalovirus Infections / Q000188:drug therapy*; D005260:Female; D015774:Ganciclovir / Q000031:analogs & derivatives* / Q000493:pharmacokinetics* / Q000627:therapeutic use; D006801:Humans; D013058:Mass Spectrometry; D000077562:Valganciclovir
chemical_list: D000998:Antiviral Agents; D000077562:Valganciclovir; D015774:Ganciclovir