title: High dose of darunavir in treatment-experienced HIV-infected adolescent results in virologic suppression and improved CD4 cell count.
abstract: We describe an unintentional significant overdose of darunavir in a treatment-experienced adolescent with decreased darunavir susceptibility and prior treatment failure on darunavir therapy. Minimal toxicity and improved virologic suppression observed with an overdose have prompted consideration of the continued use of a higher than recommended dose. Pharmacokinetic and pharmacodynamic evaluations justified the individualized use of high-dose darunavir, which resulted in virologic suppression, improved CD4 cell count, and resolution of toxicity.
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC 20010, USA. nrakhman@cnmc.org
authors.forename: Natella Y
authors.initials: NY
authors.lastname: Rakhmanina
authors.forename: Michael N
authors.initials: MN
authors.lastname: Neely
authors.forename: Edmund V
authors.initials: EV
authors.lastname: Capparelli
mesh_terms: D018791:CD4 Lymphocyte Count / Q000639:trends; D002648:Child; D000069454:Darunavir; D015658:HIV Infections / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D017320:HIV Protease Inhibitors / Q000008:administration & dosage; D015497:HIV-1; D006801:Humans; D008297:Male; D063487:Prescription Drug Misuse; D013449:Sulfonamides / Q000008:administration & dosage*; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects*
chemical_list: D017320:HIV Protease Inhibitors; D013449:Sulfonamides; D000069454:Darunavir