Graham McKerrow, HIV i-Base

A retrospective questionnaire/interview study of 63 patients taking lopinavir/ritonavir (LPV/r, Kaletra) at the Chelsea and Westminster Hospital in London found that only 43% were taking the drug with adequate food and just over a quarter of patients were taking Kaletra on an empty stomach.

Phillpot and colleagues aimed to interview a quarter of the clinics 500-odd patients taking an LPV/r-containing regimen by telephone questionnaire or at a routine clinic visit. In fact, only 63 (12.5%) patients were interviewed. 38 (60%) said they were told to eat with LPV/r, 20 (32%) said they weren’t given any information and 5 (8%) couldn’t remember.

A moderate fat meal (500-682 kcals) increases mean lopinavir AUC and Cmax by 48% and 23% respectively relative to fasting, and this increased bioavailability is why Kaletra is recommended in prescription advice to be taken with food.

The researchers comment: “For those patients who said they were given guidance on how to take Kaletra, a greater percentage took it with the correct amount of food. However patient error must be considered when carrying out retrospective questionnaires and dietary recall.”

Ref: Phillpot MN, Kabaroff E and Visser TL. Are patients given adequate dietary information when starting on a Lopinavir/Ritonavir containing HAART regimen? 6th Lipodystrophy Workshop (6th IWADRLH), Washington, 2006. Abstract 86. Antiviral Therapy 2004; 9:L50.