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Marked increase in etravirine and saquinavir plasma concentrations during atovaquone/proguanil prophylaxis

Author(s): Tommasi Chiara | Bellagamba Rita | Tempestilli Massimo | D'Avolio Antonio | Gallo Anna | Ivanovic Jelena | Nicastri Emanuele | Pucillo Leopoldo | Narciso Pasquale

Journal: Malaria Journal
ISSN 1475-2875

Volume: 10;
Issue: 1;
Start page: 141;
Date: 2011;
Original page

Abstract The case of a 32-year-old Caucasian female with multi-drug resistant HIV-1 subtype B infection treated with a salvage regimen including maraviroc, raltegravir, etravirine and unboosted saquinavir who started atovaquone/proguanil prophylaxis, is reported. The potential interactions between atovaquone/proguanil and these anti-retroviral drugs are investigated. Pharmacokinetic analyses documented a marked increase in etravirine and saquinavir plasma concentrations (+55% and +274%, respectively), but not in raltegravir and maraviroc plasma concentrations. The evidence that atovaquone/proguanil significantly interacts with etravirine and saquinavir, but not with raltegravir and maraviroc, suggests that the mechanism of interaction is related to cytochrome P450.
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