title: Administration of antiretroviral medication via enteral tubes.
abstract: OBJECTIVE
  Case reports and other published or manufacturer-provided data on the administration of antiretroviral agents through enteral feeding tubes are reviewed.
  
  
  CONCLUSIONS
  There is very limited published evidence to guide clinicians in the delivery of therapies for human immunodeficiency virus (HIV) infection by feeding tubes, especially crushed tablets and capsule contents. A search of the primary literature (through February 2012) identified a total of nine articles describing the delivery of highly active antiretroviral therapy (HAART) agents via gastrostomy (G), jejunostomy, and other feeding tubes; correspondence with pharmaceutical manufacturers yielded additional information. Most of the published evidence (from two prospective studies, one retrospective study, and six case reports) pertains to the treatment of HIV-infected children (33 of 40 cases). Although not a primary endpoint of any of the reviewed studies, viral suppression was documented in 29 of the 40 patients referenced in the reviewed articles. Manufacturer-provided information indicates that crushed darunavir tablets in suspension, as well as oral solutions of ritonavir and lopinavir-ritonavir, can be administered through G-tubes without significant loss of therapeutic efficacy.
  
  
  CONCLUSIONS
  Data regarding enteral feeding tube administration are available for 63% of commercially available oral HAART agents and are primarily limited to case reports specific to the pediatric population.
authors.affiliation: Tria Health, Overland Park, KS 66210, USA. eprohaska@triahealth.com
authors.forename: Emily S
authors.initials: ES
authors.lastname: Prohaska
authors.forename: Allison R
authors.initials: AR
authors.lastname: King
mesh_terms: D044966:Anti-Retroviral Agents / Q000737:chemistry* / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D018791:CD4 Lymphocyte Count; D004304:Dosage Forms; D004750:Enteral Nutrition / Q000379:methods*; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D010372:Pediatrics
chemical_list: D044966:Anti-Retroviral Agents; D004304:Dosage Forms