title: Successful tacrolimus treatment following renal transplant in a HIV-infected patient with raltegravir previously treated with a protease inhibitor based regimen.
abstract: A HIV positive patient who received a cadaveric renal transplantation developed tacrolimus toxicity as manifest by renal failure and decreased consciousness. This was due to atazanavir and ritonavir therapy for her HIV inhibiting the CYP3A4 hepatic enzyme resulting in accumulation of tacrolimus. Her HIV treatment was switched to raltegravir which is metabolized by UGT1A1 which does not affect tacrolimus. Tacrolimus was then reintroduced, and follow-up at 1 year demonstrated successful immunosuppression and undetectable HIV viral loads.
authors: Manchester Royal Infirmary, Manchester, UK. darrencousins@nhs.net
authors: Darren
authors: D
authors: Cousins
authors: Kate
authors: K
authors: Topping
authors: Vincent
authors: V
authors: Lee
authors: John
authors: J
authors: Sweeney
authors: Mark
authors: M
authors: Lawton
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation; D008875:Middle Aged; D011760:Pyrrolidinones / Q000627:therapeutic use*; D000068898:Raltegravir Potassium; D016559:Tacrolimus / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D007166:Immunosuppressive Agents; D011760:Pyrrolidinones; D000068898:Raltegravir Potassium; D016559:Tacrolimus