Abacavir exposure in children co-treated for tuberculosis with rifampicin and super-boosted lopinavir-ritonavir

by Rabie H, Tikiso T, Lee J, Fairlie L, Strehlau R, Bobat R, Liberty A, McIlleron H, Andrieux-Meyer I, Cotton M, Lallemant M, Denti P. Antimicrobial Agents and Chemotherapy 2020, 01923-19. doi: 10.1128/AAC.01923-19

Summary: The tuberculosis treatment rifampicin reduces the concentration of the HIV treatment lopinavir in co-treated patients. Adding ritonavir to co-formulated lopinavir–ritonavir (superboosting) has been shown to overcome this drug-drug interaction in young children. The authors conducted a pharmacokinetic study to investigate whether possible drug-drug interactions within this regimen affect concentrations of abacavir.

Abacavir bioavailability decreased 36% during treatment with rifampicin and superboosted lopinavir/ritonavir but remained within the median adult recommended exposure, except for the 3-4.9 kg weight-band where exposures were higher. Although abacavir exposure significantly decreased during concomitant administration of rifampicin and lopinavir/ritonavir, it remained within acceptable ranges.

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