title: Continuous intravenous infusion of enfuvirtide in a patient with a multidrug-resistant HIV strain.
abstract: Case description To evaluate whether continuous intravenous (i.v.) administration of enfuvirtide (T20) could be a suitable alternative to subcutaneous (s.c.) administration of T20 in a patient with extensively drug-resistant HIV experiencing difficulties administering T20 subcutaneously. T20 was administered to a patient through 100 mL cassettes once daily via a CADD. Plasma samples were drawn and the pharmacokinetic profile compared to that of s.c. twice daily administration of T20. Also, viral replication and CD4+ count were monitored over a period of 9 months for this study. Continuous i.v. administration of T20 resulted in significantly higher T20 plasma levels compared to s.c. administration, continued viral suppression, a rise in CD4+ count and strong patient preference over s.c. administration. Conclusion This method of T20 administration may be a suitable alternative for selected patients who are not able to tolerate it when given subcutaneously. It may even be considered a priori in selected patients with extensive viral resistance who are unable or unwilling to inject T20 subcutaneously.
authors.affiliation: Department of Clinical Pharmacy, University Medical Center Utrecht, P.O. Box 85500, HP. D.00.225, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. robertneijzen@gmail.com.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Neijzen
authors.affiliation: Department of Clinical Pharmacy, University Medical Center Utrecht, P.O. Box 85500, HP. D.00.225, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Erik M
authors.initials: EM
authors.lastname: Van Maarseveen
authors.affiliation: Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Andy I M
authors.initials: AI
authors.lastname: Hoepelman
authors.affiliation: Department of Medical Microbiology, Virology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Annemarie M J
authors.initials: AM
authors.lastname: Wensing
authors.affiliation: Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Turin, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bonora
authors.affiliation: Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Turin, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Avolio
authors.affiliation: Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Tania
authors.initials: T
authors.lastname: Mudrikova
mesh_terms: D000368:Aged; D015704:CD4 Antigens / Q000097:blood; D018432:Drug Resistance, Multiple / Q000187:drug effects*; D000077560:Enfuvirtide; D006678:HIV / Q000187:drug effects; D015700:HIV Envelope Protein gp41 / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D007262:Infusions, Intravenous; D007279:Injections, Subcutaneous; D057240:Patient Preference; D010446:Peptide Fragments / Q000008:administration & dosage* / Q000493:pharmacokinetics*
chemical_list: D015704:CD4 Antigens; D015700:HIV Envelope Protein gp41; D010446:Peptide Fragments; D000077560:Enfuvirtide
keywords: AIDS; Continuous intravenous therapy; Enfuvirtide; HIV; Resistance