Genotyping of CYP2B6 and therapeutic drug monitoring in an HIV-infected patient with high efavirenz plasma concentrations and severe CNS side-effects.
We present a case with important pharmacogenetic and pharmacokinetic aspects of antiretroviral therapy in a patient with high efavirenz concentrations, severe CNS side-effects and low lopinavir concentrations. Despite therapeutic drug monitoring and subsequent efavirenz dosage reductions, side-effects did not resolve completely and lopinavir concentrations remained relatively low.
Mathiesen
Sofie
S
Department of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen. sofiemath@stud.ku.dk
Justesen
Ulrik Stenz
US
Von Lüttichau
Hans-Rudolf
HR
Hansen
Ann-Brit Eg
AB
D000328:Adult; D000480:Alkynes; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000097:blood* / Q000493:pharmacokinetics / Q000627:therapeutic use; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics* / Q000378:metabolism; D048588:Benzoxazines; D002493:Central Nervous System Diseases / Q000097:blood / Q000139:chemically induced* / Q000201:enzymology / Q000235:genetics; D003521:Cyclopropanes; D065702:Cytochrome P-450 CYP2B6; D016903:Drug Monitoring; D005838:Genotype; D006678:HIV; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy / Q000201:enzymology* / Q000235:genetics; D006801:Humans; D061466:Lopinavir; D008297:Male; D010078:Oxazines / Q000009:adverse effects / Q000097:blood* / Q000493:pharmacokinetics / Q000627:therapeutic use; D010089:Oxidoreductases, N-Demethylating / Q000235:genetics* / Q000378:metabolism; D011744:Pyrimidinones / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use
D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D010078:Oxazines; D011744:Pyrimidinones; D061466:Lopinavir; D001189:Aryl Hydrocarbon Hydroxylases; C585599:CYP2B6 protein, human; D065702:Cytochrome P-450 CYP2B6; D010089:Oxidoreductases, N-Demethylating; C098320:efavirenz