title: Marked increase in etravirine and saquinavir plasma concentrations during atovaquone/proguanil prophylaxis.
abstract: The case of a 32-year-old Caucasian female with multi-drug resistant HIV-1 subtype B infection treated with a salvage regimen including maraviroc, raltegravir, etravirine and unboosted saquinavir who started atovaquone/proguanil prophylaxis, is reported. The potential interactions between atovaquone/proguanil and these anti-retroviral drugs are investigated. Pharmacokinetic analyses documented a marked increase in etravirine and saquinavir plasma concentrations (+55% and +274%, respectively), but not in raltegravir and maraviroc plasma concentrations. The evidence that atovaquone/proguanil significantly interacts with etravirine and saquinavir, but not with raltegravir and maraviroc, suggests that the mechanism of interaction is related to cytochrome P450.
authors: National Institute for Infectious Diseases L, Spallanzani, Via Portuense 292, 00149 Rome, Italy. chiara.tommasi@inmi.it
authors: Chiara
authors: C
authors: Tommasi
authors: Rita
authors: R
authors: Bellagamba
authors: Massimo
authors: M
authors: Tempestilli
authors: Antonio
authors: A
authors: D'Avolio
authors: Anna L
authors: AL
authors: Gallo
authors: Jelena
authors: J
authors: Ivanovic
authors: Emanuele
authors: E
authors: Nicastri
authors: Leopoldo P
authors: LP
authors: Pucillo
authors: Pasquale
authors: P
authors: Narciso
references: AIDS. 2010 Apr 24;24(7):1088-90
references: 20386384
references: AIDS. 2010 May 15;24(8):1223-6
references: 20299957
references: Antivir Ther. 2009;14(5):607-18
references: 19704163
references: Am J Trop Med Hyg. 2007 Feb;76(2):208-23
references: 17297027
references: Ther Drug Monit. 2010 Feb;32(1):86-92
references: 20040898
references: Ther Drug Monit. 2008 Dec;30(6):662-9
references: 18824956
references: Biochemistry. 1998 Mar 17;37(11):3594-601
references: 9530286
references: Clin Pharmacokinet. 2009;48(9):561-74
references: 19725591
references: Antimicrob Agents Chemother. 1998 Dec;42(12):3157-62
references: 9835508
references: Curr Opin Investig Drugs. 2007 Aug;8(8):669-81
references: 17668369
references: Clin Pharmacol Ther. 2008 Feb;83(2):293-9
references: 17713476