title: Low Third-Trimester Serum Levels of Lamivudine/Zidovudine and Lopinavir/Ritonavir in an HIV-Infected Pregnant Woman with Gastric Bypass.
abstract: Pharmacokinetics of lamivudine (3TC)/zidovudine (ZDV) and lopinavir/ritonavir (LPV/r) are described in a gravid 27-year-old HIV-infected woman with gastric bypass. Blood levels were obtained for these medications at time points 0 (predose) and 1, 2, 4, 6, 8, and 12 hours postdose. For these times, the levels (µg/mL) of 3TC were 0.0801, 0.69, 0.339, 0.237, 0.202, 0.108, and 0.0461; the levels of ZDV were 0.0153, 0.433, 0.0717, 0.0481, 0.0107, 0.0214, and 0.00864; the levels of lopinavir (LPV) were 2.45, 2.64, 1.95, 2.78, 3.83, 3.20, and 1.92; and the levels of ritonavir (RTV) were 0.09, 0.10, 0.07, 0.11, 0.15, 0.15, and 0.06. These data suggest that gastric bypass affected these antiretroviral drug levels. A functional, intact small bowel is responsible for absorption of these medications.
authors.affiliation: Division of Pediatric Infectious Diseases, Miller Children's Hospital Long Beach, Long Beach, CA, USA dmichalik@memorialcare.org.
authors.forename: David E
authors.initials: DE
authors.lastname: Michalik
authors.affiliation: Long Beach Memorial Medical Center, Long Beach, CA, USA.
authors.forename: Janielle T
authors.initials: JT
authors.lastname: Jackson-Alvarez
authors.affiliation: Long Beach Memorial Medical Center, Long Beach, CA, USA.
authors.forename: Roxana
authors.initials: R
authors.lastname: Flores
authors.affiliation: Long Beach Memorial Medical Center, Long Beach, CA, USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Tolentino-Baldridge
authors.affiliation: Division of Pediatric Infectious Diseases, Miller Children's Hospital Long Beach, Long Beach, CA, USA.
authors.forename: Jagmohan S
authors.initials: JS
authors.lastname: Batra
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000097:blood / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D015390:Gastric Bypass; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D019259:Lamivudine / Q000097:blood / Q000627:therapeutic use*; D061466:Lopinavir / Q000097:blood / Q000627:therapeutic use*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000188:drug therapy* / Q000601:surgery; D011263:Pregnancy Trimester, Third / Q000097:blood*; D019438:Ritonavir / Q000097:blood / Q000627:therapeutic use*; D015215:Zidovudine / Q000097:blood / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D004338:Drug Combinations; C109078:lamivudine, zidovudine drug combination; D061466:Lopinavir; D019259:Lamivudine; D015215:Zidovudine; D019438:Ritonavir
keywords: antiretroviral therapy; gastric bypass; pharmacokinetics; pregnancy