{"id":767,"date":"2008-06-12T20:35:40","date_gmt":"2008-06-12T19:35:40","guid":{"rendered":"http:\/\/localhost\/new\/htb\/?p=767"},"modified":"2013-08-28T07:00:13","modified_gmt":"2013-08-28T07:00:13","slug":"choice-of-arvs-for-people-after-organ-transplantation","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/767","title":{"rendered":"Choice of ARVs for people after organ transplantation"},"content":{"rendered":"<p><strong>Simon Collins, HIV i-Base<\/strong><\/p>\n<p><strong>A poster from Kings College and St Thomas presented three case studies of ARV drug interactions with immunosuppressents in transplant recipients, that resulted in significant toxicity and treatment changes.<\/strong><\/p>\n<p>Case 1 was a 56 year old woman who underwent liver transplantation for hepatitis B who subsequently acquired HIV. After starting saquinavir\/ritonavir based HAART (1000\/100mg BID), her previously stable ciclosporin levels (normal range &lt;200 mcg\/L) peaked at 1005 mcg\/L, requiring hospital admission for renal function. This required reducing the ciclosporin dose to 25 mg every third day.<\/p>\n<p>Case 2 was a 37 year old HIV positive man on stable tacrolimus based immunosuppression following a hepatitis B-related liver transplant. When efavirenz was switched to nevirapine tacrolimus levels increased, peaking at 22 mcg\/mL (normal range 1-12 mcg\/L) and with worsening renal function.<\/p>\n<p>Case 3 was a 40 year old HIV positive man underwent renal transplantation for HIVAN. His HAART regimen included fosamprenavir\/ritonavir (700\/100 mg BD). On starting cyclosporin, his fosamprenavir levels increased to 4000 ng\/mL (therapeutic range &lt;400 ng\/mL) associated with disabling diarrhoea requiring discontinuation of ritonavir.<\/p>\n<p>The researchers noted the importance of an awareness on the potential interaction between protease inhibitors and immune-suppressing treatment, and suggested &#8220;that patients with RTI options should also consider raltegravir and T-20 during the peri-transplant period because of their minimal interactions with cytochrome P450 and P-glycoprotein&#8221;.<\/p>\n<p class=\"ref\">Reference:<\/p>\n<p class=\"ref\">Nathan B at al. Interactions between immunosuppressants and antiretroviral therapy (ARVT) in solid organ transplant recipients: a role for non-nucleoside reverse transcriptase and protease inhibitor-sparing regimes. Poster 124.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Simon Collins, HIV i-Base A poster from Kings College and St Thomas presented three case studies of ARV drug interactions with immunosuppressents in transplant recipients, that resulted in significant toxicity and treatment changes. Case 1 was a 56 year old &hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[50],"class_list":["post-767","post","type-post","status-publish","format-standard","hentry","category-conference-reports","tag-bhiva-14th-2008"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/767","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=767"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/767\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=767"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=767"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=767"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}