Once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, HIV-infected, treatment-experienced children: Comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir

Objectives: Data on lopinavir/ritonavir tablets administered once daily in children are limited. We compared the pharmacokinetics (PK) of lopinavir/ritonavir twice daily versus once daily in virologically suppressed, HIV-infected children, and assessed the virological outcome, at 48 weeks, in childr...

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Main Authors: Chokephaibulkit K., Nuntarukchaikul M., Phongsamart W., Wittawatmongkol O., Lapphra K., Vanprapar N., Cressey T.R.
Format: Article
Language:English
Published: 2014
Online Access:http://www.scopus.com/inward/record.url?eid=2-s2.0-84869462249&partnerID=40&md5=afdc589e473e64d7a54b76da5bcdce53
http://cmuir.cmu.ac.th/handle/6653943832/903
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spelling th-cmuir.6653943832-9032014-08-29T09:02:18Z Once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, HIV-infected, treatment-experienced children: Comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir Chokephaibulkit K. Nuntarukchaikul M. Phongsamart W. Wittawatmongkol O. Lapphra K. Vanprapar N. Cressey T.R. Objectives: Data on lopinavir/ritonavir tablets administered once daily in children are limited. We compared the pharmacokinetics (PK) of lopinavir/ritonavir twice daily versus once daily in virologically suppressed, HIV-infected children, and assessed the virological outcome, at 48 weeks, in children receiving the regimen of lopinavir/ritonavir once daily. Patients and methods: HIV-infected children receiving a twice-daily lopinavir/ritonavir-based regimen and with an HIV-1 RNA viral load (VL) <40 copies/mL for at least 3 months were enrolled. Intensive steady-state 12 h blood sampling for PK assessment was performed at enrolment. Immediately afterwards, the lopinavir/ritonavir dose was changed to once daily with the equivalent daily dose, and intensive steady-state 24 h blood sampling was repeated 2 weeks later. If the lopinavir C trough was <1.0 μg/mL, the lopinavir/ritonavir dose was increased by 20%-30% and C trough measurement repeated. CD4 cell counts and VL were determined at baseline and at 12, 24 and 48 weeks. Results: Twelve children were enrolled. The median age was 13.1 years. Lopinavir AUC 0-24 following twice-daily and once-daily dosing was 169.7 (124.0-200.8) and 167.1 (95.1-228.1) · h/mL, respectively. Seven children, including all six concomitantly receiving efavirenz, had a C trough <1.0 μg/mL with once-daily lopinavir/ritonavir dosing, and four of seven children had a C trough <1.0 μg/mL after dose adjustment. All children maintained virological suppression throughout the 48 week period. Conclusions: Lopinavir/ritonavir-based once-daily regimens could simplify therapy in children/adolescents with virological control, but a lower lopinavir C trough was evident. Further efficacy studies of lopinavir/ritonavir once daily in children are necessary before routinely recommending this dosing strategy. © The Author 2012. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. 2014-08-29T09:02:18Z 2014-08-29T09:02:18Z 2012 Article 3057453 10.1093/jac/dks332 JACHD http://www.scopus.com/inward/record.url?eid=2-s2.0-84869462249&partnerID=40&md5=afdc589e473e64d7a54b76da5bcdce53 http://cmuir.cmu.ac.th/handle/6653943832/903 English
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
language English
description Objectives: Data on lopinavir/ritonavir tablets administered once daily in children are limited. We compared the pharmacokinetics (PK) of lopinavir/ritonavir twice daily versus once daily in virologically suppressed, HIV-infected children, and assessed the virological outcome, at 48 weeks, in children receiving the regimen of lopinavir/ritonavir once daily. Patients and methods: HIV-infected children receiving a twice-daily lopinavir/ritonavir-based regimen and with an HIV-1 RNA viral load (VL) <40 copies/mL for at least 3 months were enrolled. Intensive steady-state 12 h blood sampling for PK assessment was performed at enrolment. Immediately afterwards, the lopinavir/ritonavir dose was changed to once daily with the equivalent daily dose, and intensive steady-state 24 h blood sampling was repeated 2 weeks later. If the lopinavir C trough was <1.0 μg/mL, the lopinavir/ritonavir dose was increased by 20%-30% and C trough measurement repeated. CD4 cell counts and VL were determined at baseline and at 12, 24 and 48 weeks. Results: Twelve children were enrolled. The median age was 13.1 years. Lopinavir AUC 0-24 following twice-daily and once-daily dosing was 169.7 (124.0-200.8) and 167.1 (95.1-228.1) · h/mL, respectively. Seven children, including all six concomitantly receiving efavirenz, had a C trough <1.0 μg/mL with once-daily lopinavir/ritonavir dosing, and four of seven children had a C trough <1.0 μg/mL after dose adjustment. All children maintained virological suppression throughout the 48 week period. Conclusions: Lopinavir/ritonavir-based once-daily regimens could simplify therapy in children/adolescents with virological control, but a lower lopinavir C trough was evident. Further efficacy studies of lopinavir/ritonavir once daily in children are necessary before routinely recommending this dosing strategy. © The Author 2012. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
format Article
author Chokephaibulkit K.
Nuntarukchaikul M.
Phongsamart W.
Wittawatmongkol O.
Lapphra K.
Vanprapar N.
Cressey T.R.
spellingShingle Chokephaibulkit K.
Nuntarukchaikul M.
Phongsamart W.
Wittawatmongkol O.
Lapphra K.
Vanprapar N.
Cressey T.R.
Once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, HIV-infected, treatment-experienced children: Comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir
author_facet Chokephaibulkit K.
Nuntarukchaikul M.
Phongsamart W.
Wittawatmongkol O.
Lapphra K.
Vanprapar N.
Cressey T.R.
author_sort Chokephaibulkit K.
title Once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, HIV-infected, treatment-experienced children: Comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir
title_short Once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, HIV-infected, treatment-experienced children: Comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir
title_full Once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, HIV-infected, treatment-experienced children: Comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir
title_fullStr Once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, HIV-infected, treatment-experienced children: Comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir
title_full_unstemmed Once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, HIV-infected, treatment-experienced children: Comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir
title_sort once- versus twice-daily lopinavir/ritonavir tablets in virologically suppressed, hiv-infected, treatment-experienced children: comparative pharmacokinetics and virological outcome after switching to once-daily lopinavir/ritonavir
publishDate 2014
url http://www.scopus.com/inward/record.url?eid=2-s2.0-84869462249&partnerID=40&md5=afdc589e473e64d7a54b76da5bcdce53
http://cmuir.cmu.ac.th/handle/6653943832/903
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