All Rights Reserved. Search for other works by this author on: It has demonstrated efficacy in both treatment-naive and -experienced patients in combination with other ARV drugs.

This brief review will look at the novel agents dolutegravir, raltegravir, elvitegravir, cobicistat, tenofovir alafenamide fumarate and atazanavir, all of which have been licensed relatively recently, and describe issues relevant to renal function, creatinine handling and potential nephrotoxicity. To study this, we measured dolutegravir plasma concentrations in samples of blood entering and leaving the dialyzer and of the resulting dialysate from 5 HIV-infected patients with end-stage renal disease. Chronic kidney disease (CKD) is a critical comorbidity for patients living with HIV, with an estimated prevalence between 2.4 and 17%. James Milburn, Rachael Jones, Jeremy B.

2014 May;12(5):535-44. doi: 10.1586/14787210.2014.907525. While combination antiretroviral (ARV) treatments reduce CKD in the HIV-infected population overall, some ARV drugs have been shown to be nephrotoxic and associated with worsening renal function. (This study is registered at ClinicalTrials.gov under registration number Vacuum devices. The dolutegravir concentrations after the dialysis session remained far above the protein-binding-adjusted inhibitory concentration. The case of StribildNovel antiretroviral drugs and renal function monitoring of HIV patientsHighly active antiretroviral therapy and the kidney: an update on antiretroviral medications for nephrologistsClinical pharmacology profile of raltegravir, an HIV-1 integrase strand transfer inhibitorMinimal removal of raltegravir by haemodialysis in HIV-infected patients with end-stage renal diseaseDolutegravir versus raltegravir in antiretroviral experienced, integrase-inhibitor-naive adults with HIV: week 48 results from the randomised, double-blind, non-inferiority SAILING studyOnce-daily dolutegravir versus raltegravir in antiretroviral-naive adults with HIV-1 infection: 48 week results from the randomised, double-blind, non-inferiority SPRING-2 studyEffects of switching from Efavirenz to Raltegravir on endothelial function, bone mineral metabolism, inflammation, and renal function: a randomised control studySevere acute renal failure associated with rhabdomyolysis during treatment with raltegravir.

COBI has greater CYP450 enzyme specificity than RTV, another pharmaco-enhancer, with no effect on CPY1A2, CYP2C9 or CYP2C19, suggesting that there should be fewer drug–drug interactions than observed with RTV [In phase 3 trials of Stribild compared with Atripla (efavirenz/TDF/FTC), five patients had renal adverse effects that required treatment discontinuation prior to Week 48 and all were in the treatment arm containing COBI. As such, it is always administered with a CYP3A inhibitor, either COBI or ritonavir (RTV, which act as pharmacokinetic boosters to facilitate once-daily dosing [Phase 3 trials comparing EVG to RTG showed no difference in renal function between the two drugs, but a median decrease in eGFR from baseline to 96 weeks of 10.8 mL/min/1.73 mDTG is the third integrase inhibitor to be approved (in January 2014 in Europe) and is available as an individual agent for once-daily dosing or in a fixed drug combination with abacavir and lamivudine, branded under the trade name Triumeq [Overall therefore, DTG induces a noticeable increase in serum creatinine following initiation of therapy due to non-pathologic tubular blockade of creatinine secretion through the inhibition of OCT2. 2017 Aug;42(4):559-572. doi: 10.1007/s13318-016-0394-6. Data on dolutegravir removal by hemodialysis are lacking. Female subjects must agree to use contraception until the follow-up visit. ATZ is metabolized mainly by cytochrome P450 3A4 and is primarily excreted in faeces (79%), with only 7% of ATZ excreted unchanged in the urine, although the solubility of ATZ decreases with an increase in the alkalinity of urine [Alongside its association with nephrolithiasis, patients on ATZ have been shown to have significant reductions in eGFR. R.J. has received funding for educational work, board reviews and travel from Gilead, ViiV, AbbVie, BMS and Janssen. Such patients are increasingly affected by diseases associated with ageing, including cardiovascular disease and CKD, and the prevalence of risk factors such as smoking and dyslipidaemia is increased in this population.

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