Antiretroviral blood levels in HIV/HCV-coinfected patients with cirrhosis after liver transplant: a report of three cases

Transpl Infect Dis. 2015 Feb;17(1):147-53. doi: 10.1111/tid.12339. Epub 2015 Jan 12.

Abstract

Since the introduction of combined antiretroviral therapy, human immunodeficiency virus (HIV) infection is no longer a contraindication for solid organ transplantation. In HIV/hepatitis C virus (HCV)-coinfected patients undergoing liver transplantation, HCV-related cirrhosis, drug-drug interactions, and calcineurin inhibitors-related toxicity affect clinical outcomes. Therapeutic drug monitoring can be useful to assess antiretroviral over- or underexposure in this cohort. We report the clinical characteristics along with antiretroviral trough levels of maraviroc, darunavir, and etravirine in 3 HIV/HCV-coinfected liver transplant recipients who developed post-transplant liver cirrhosis.

Keywords: HIV/HCV coinfection; antiretrovirals; c-ART; cirrhosis; liver transplant; therapaeutic drug monitoring.

Publication types

  • Case Reports

MeSH terms

  • Anti-Retroviral Agents / blood*
  • Anti-Retroviral Agents / pharmacokinetics
  • Coinfection
  • Cyclohexanes / blood
  • Cyclohexanes / pharmacokinetics
  • Darunavir / blood
  • Darunavir / pharmacokinetics
  • Drug Monitoring
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • HIV Infections / surgery
  • Hepatitis C / complications
  • Hepatitis C / drug therapy*
  • Hepatitis C / surgery
  • Humans
  • Liver Cirrhosis / drug therapy*
  • Liver Cirrhosis / surgery
  • Liver Transplantation / adverse effects*
  • Male
  • Maraviroc
  • Middle Aged
  • Nitriles
  • Pyridazines / blood
  • Pyridazines / pharmacokinetics
  • Pyrimidines
  • Triazoles / blood
  • Triazoles / pharmacokinetics

Substances

  • Anti-Retroviral Agents
  • Cyclohexanes
  • Nitriles
  • Pyridazines
  • Pyrimidines
  • Triazoles
  • etravirine
  • Maraviroc
  • Darunavir