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Lower atovaquone/proguanil concentrations in patients taking efavirenz, lopinavir/ritonavir or atazanavir/ritonavir.

Research paper by Matthijs M van Luin, Marchina E ME Van der Ende, Clemens C Richter, Mirjam M Visser, Diari D Faraj, Andre A Van der Ven, Luc L Gelinck, Frank F Kroon, Ferdinand W FW Wit, Ron H N RH Van Schaik, Paul F M PF Kuks, David M DM Burger

Indexed on: 20 Mar '10Published on: 20 Mar '10Published in: AIDS (London, England)



Abstract

HIV-infected travellers frequently use atovaquone/proguanil as malaria prophylaxis. We compared atovaquone/proguanil pharmacokinetics between healthy volunteers and HIV-infected patients taking efavirenz, lopinavir/ritonavir or atazanavir/ritonavir. The geometric mean ratio (95% confidence interval) area under the curve (AUC)0-->t for atovaquone relative to the healthy volunteers was 0.25 (0.16-0.38), 0.26 (0.17-0.41) and 0.54 (0.35-0.83) for patients on efavirenz, lopinavir/ritonavir and atazanavir/ritonavir, respectively. Proguanil plasma concentrations were also significantly lower (38-43%). Physicians should be alert for atovaquone/proguanil prophylaxis failures in patients taking efavirenz, lopinavir/ritonavir or atazanavir/ritonavir.

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