Higher plasma drug levels in elderly people living with HIV treated with darunavir
The proportion of elderly people living with HIV-1 (PLHIV) is rising. In older patients, comorbidities and concomitant medications are more frequent, increasing the risk of potential drug-drug interactions (PDDIs). Data on the pharmacokinetics of ART in individuals aged ≥ 65 years of age are scarce....
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| Veröffentlicht in: | PloS one 2021-02, Vol.16 (2), p.e0246171 |
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| creator | Tyrberg, Erika Edén, Arvid Eriksen, Jaran Nilsson, Staffan Treutiger, Carl Johan Thalme, Anders Mellgren, Åsa Gisslén, Magnus Andersson, Lars-Magnus |
| description | The proportion of elderly people living with HIV-1 (PLHIV) is rising. In older patients, comorbidities and concomitant medications are more frequent, increasing the risk of potential drug-drug interactions (PDDIs). Data on the pharmacokinetics of ART in individuals aged ≥ 65 years of age are scarce. We compared plasma drug levels of ART, PDDIs, and side-effects in PLHIV aged ≥ 65 years of age, with controls ≤ 49 years of age.
Patients ≥ 65 years of age and controls ≤ 49 years of age, all of whom were on stable treatment with atazanavir (ATV), darunavir (DRV), or efavirenz (EFV) were included cross-sectionally. Plasma drug levels of ART were analyzed, comorbidities, concomitant medication, adherence, and side-effects recorded, and PDDIs analyzed using drug interactions databases.
Between 2013 and 2015, we included 100 individuals ≥ 65 years of age (study group) and 99 controls (≤ 49 years of age). Steady-state DRV concentrations were significantly higher in the study group than in the control group (p = 0.047). In the ATV group there was a trend towards a significant difference (p = 0.056). No significant differences were found in the EFV arm. The DRV arm had a higher frequency of reported side-effects than the ATV and EFV arms in the study group (36.7% vs. 0% and 23.8% respectively (p = 0.014), with significant differences between DRV vs. ATV, and EFV vs. ATV).
Higher steady-state plasma levels of DRV and ATV (but not EFV) were found in PLHIV aged ≥ 65 years of age, compared to controls ≤ 49 years of age. |
| doi_str_mv | 10.1371/journal.pone.0246171 |
| format | Article |
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Patients ≥ 65 years of age and controls ≤ 49 years of age, all of whom were on stable treatment with atazanavir (ATV), darunavir (DRV), or efavirenz (EFV) were included cross-sectionally. Plasma drug levels of ART were analyzed, comorbidities, concomitant medication, adherence, and side-effects recorded, and PDDIs analyzed using drug interactions databases.
Between 2013 and 2015, we included 100 individuals ≥ 65 years of age (study group) and 99 controls (≤ 49 years of age). Steady-state DRV concentrations were significantly higher in the study group than in the control group (p = 0.047). In the ATV group there was a trend towards a significant difference (p = 0.056). No significant differences were found in the EFV arm. The DRV arm had a higher frequency of reported side-effects than the ATV and EFV arms in the study group (36.7% vs. 0% and 23.8% respectively (p = 0.014), with significant differences between DRV vs. ATV, and EFV vs. ATV).
Higher steady-state plasma levels of DRV and ATV (but not EFV) were found in PLHIV aged ≥ 65 years of age, compared to controls ≤ 49 years of age.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0246171</identifier><identifier>PMID: 33539440</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>adherence ; Age ; Aged patients ; Antiretroviral agents ; Antiretroviral drugs ; antiretroviral medications ; Antiretroviral therapy ; Biology and Life Sciences ; Care and treatment ; Chromatography ; Clinical Medicine ; Complications and side effects ; Darunavir ; Demographic aspects ; Diagnosis ; Dosage and administration ; Drug dosages ; Drug interactions ; Drug therapy ; Editing ; Efavirenz ; Funding ; Health risks ; High performance liquid chromatography ; High pressure ; HIV ; HIV infection ; Hospitals ; Human immunodeficiency virus ; individuals ; infection ; Infectious diseases ; Integrase ; Klinisk medicin ; Laboratories ; Life expectancy ; Life span ; Liquid chromatography ; Medicin och hälsovetenskap ; Medicine and Health Sciences ; Nucleosides ; older ; Older people ; People and Places ; Pharmacology ; Plasma ; polypharmacy ; population ; Prescription drugs ; Protease inhibitors ; Proteinase inhibitors ; Public health ; Questionnaires ; Reviews ; risk ; Risk factors ; Science & Technology - Other Topics ; survival</subject><ispartof>PloS one, 2021-02, Vol.16 (2), p.e0246171</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Tyrberg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Tyrberg et al 2021 Tyrberg et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c894t-cec0acfb154267a685de07955b3963eeb51a36fc2c3203cf0f4d67752745c4353</citedby><cites>FETCH-LOGICAL-c894t-cec0acfb154267a685de07955b3963eeb51a36fc2c3203cf0f4d67752745c4353</cites><orcidid>0000-0003-1146-5615 ; 0000-0003-3253-4712</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7861408/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7861408/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,552,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33539440$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://gup.ub.gu.se/publication/305781$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:146101685$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://research.chalmers.se/publication/522372$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><contributor>Kumar, Santosh</contributor><creatorcontrib>Tyrberg, Erika</creatorcontrib><creatorcontrib>Edén, Arvid</creatorcontrib><creatorcontrib>Eriksen, Jaran</creatorcontrib><creatorcontrib>Nilsson, Staffan</creatorcontrib><creatorcontrib>Treutiger, Carl Johan</creatorcontrib><creatorcontrib>Thalme, Anders</creatorcontrib><creatorcontrib>Mellgren, Åsa</creatorcontrib><creatorcontrib>Gisslén, Magnus</creatorcontrib><creatorcontrib>Andersson, Lars-Magnus</creatorcontrib><title>Higher plasma drug levels in elderly people living with HIV treated with darunavir</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The proportion of elderly people living with HIV-1 (PLHIV) is rising. In older patients, comorbidities and concomitant medications are more frequent, increasing the risk of potential drug-drug interactions (PDDIs). Data on the pharmacokinetics of ART in individuals aged ≥ 65 years of age are scarce. We compared plasma drug levels of ART, PDDIs, and side-effects in PLHIV aged ≥ 65 years of age, with controls ≤ 49 years of age.
Patients ≥ 65 years of age and controls ≤ 49 years of age, all of whom were on stable treatment with atazanavir (ATV), darunavir (DRV), or efavirenz (EFV) were included cross-sectionally. Plasma drug levels of ART were analyzed, comorbidities, concomitant medication, adherence, and side-effects recorded, and PDDIs analyzed using drug interactions databases.
Between 2013 and 2015, we included 100 individuals ≥ 65 years of age (study group) and 99 controls (≤ 49 years of age). Steady-state DRV concentrations were significantly higher in the study group than in the control group (p = 0.047). In the ATV group there was a trend towards a significant difference (p = 0.056). No significant differences were found in the EFV arm. The DRV arm had a higher frequency of reported side-effects than the ATV and EFV arms in the study group (36.7% vs. 0% and 23.8% respectively (p = 0.014), with significant differences between DRV vs. ATV, and EFV vs. ATV).
Higher steady-state plasma levels of DRV and ATV (but not EFV) were found in PLHIV aged ≥ 65 years of age, compared to controls ≤ 49 years of age.</description><subject>adherence</subject><subject>Age</subject><subject>Aged patients</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>antiretroviral medications</subject><subject>Antiretroviral therapy</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Chromatography</subject><subject>Clinical Medicine</subject><subject>Complications and side effects</subject><subject>Darunavir</subject><subject>Demographic aspects</subject><subject>Diagnosis</subject><subject>Dosage and administration</subject><subject>Drug dosages</subject><subject>Drug interactions</subject><subject>Drug therapy</subject><subject>Editing</subject><subject>Efavirenz</subject><subject>Funding</subject><subject>Health risks</subject><subject>High performance liquid chromatography</subject><subject>High pressure</subject><subject>HIV</subject><subject>HIV infection</subject><subject>Hospitals</subject><subject>Human immunodeficiency virus</subject><subject>individuals</subject><subject>infection</subject><subject>Infectious diseases</subject><subject>Integrase</subject><subject>Klinisk medicin</subject><subject>Laboratories</subject><subject>Life expectancy</subject><subject>Life span</subject><subject>Liquid chromatography</subject><subject>Medicin och hälsovetenskap</subject><subject>Medicine and Health Sciences</subject><subject>Nucleosides</subject><subject>older</subject><subject>Older people</subject><subject>People and Places</subject><subject>Pharmacology</subject><subject>Plasma</subject><subject>polypharmacy</subject><subject>population</subject><subject>Prescription drugs</subject><subject>Protease inhibitors</subject><subject>Proteinase inhibitors</subject><subject>Public 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plasma drug levels in elderly people living with HIV treated with darunavir</title><author>Tyrberg, Erika ; Edén, Arvid ; Eriksen, Jaran ; Nilsson, Staffan ; Treutiger, Carl Johan ; Thalme, Anders ; Mellgren, Åsa ; Gisslén, Magnus ; Andersson, Lars-Magnus</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c894t-cec0acfb154267a685de07955b3963eeb51a36fc2c3203cf0f4d67752745c4353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>adherence</topic><topic>Age</topic><topic>Aged patients</topic><topic>Antiretroviral agents</topic><topic>Antiretroviral drugs</topic><topic>antiretroviral medications</topic><topic>Antiretroviral therapy</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>Chromatography</topic><topic>Clinical Medicine</topic><topic>Complications and side effects</topic><topic>Darunavir</topic><topic>Demographic 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Staffan</au><au>Treutiger, Carl Johan</au><au>Thalme, Anders</au><au>Mellgren, Åsa</au><au>Gisslén, Magnus</au><au>Andersson, Lars-Magnus</au><au>Kumar, Santosh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Higher plasma drug levels in elderly people living with HIV treated with darunavir</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-02-04</date><risdate>2021</risdate><volume>16</volume><issue>2</issue><spage>e0246171</spage><pages>e0246171-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The proportion of elderly people living with HIV-1 (PLHIV) is rising. In older patients, comorbidities and concomitant medications are more frequent, increasing the risk of potential drug-drug interactions (PDDIs). Data on the pharmacokinetics of ART in individuals aged ≥ 65 years of age are scarce. We compared plasma drug levels of ART, PDDIs, and side-effects in PLHIV aged ≥ 65 years of age, with controls ≤ 49 years of age.
Patients ≥ 65 years of age and controls ≤ 49 years of age, all of whom were on stable treatment with atazanavir (ATV), darunavir (DRV), or efavirenz (EFV) were included cross-sectionally. Plasma drug levels of ART were analyzed, comorbidities, concomitant medication, adherence, and side-effects recorded, and PDDIs analyzed using drug interactions databases.
Between 2013 and 2015, we included 100 individuals ≥ 65 years of age (study group) and 99 controls (≤ 49 years of age). Steady-state DRV concentrations were significantly higher in the study group than in the control group (p = 0.047). In the ATV group there was a trend towards a significant difference (p = 0.056). No significant differences were found in the EFV arm. The DRV arm had a higher frequency of reported side-effects than the ATV and EFV arms in the study group (36.7% vs. 0% and 23.8% respectively (p = 0.014), with significant differences between DRV vs. ATV, and EFV vs. ATV).
Higher steady-state plasma levels of DRV and ATV (but not EFV) were found in PLHIV aged ≥ 65 years of age, compared to controls ≤ 49 years of age.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33539440</pmid><doi>10.1371/journal.pone.0246171</doi><tpages>e0246171</tpages><orcidid>https://orcid.org/0000-0003-1146-5615</orcidid><orcidid>https://orcid.org/0000-0003-3253-4712</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-02, Vol.16 (2), p.e0246171 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2486455592 |
| source | DOAJ Directory of Open Access Journals; SWEPUB Freely available online; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | adherence Age Aged patients Antiretroviral agents Antiretroviral drugs antiretroviral medications Antiretroviral therapy Biology and Life Sciences Care and treatment Chromatography Clinical Medicine Complications and side effects Darunavir Demographic aspects Diagnosis Dosage and administration Drug dosages Drug interactions Drug therapy Editing Efavirenz Funding Health risks High performance liquid chromatography High pressure HIV HIV infection Hospitals Human immunodeficiency virus individuals infection Infectious diseases Integrase Klinisk medicin Laboratories Life expectancy Life span Liquid chromatography Medicin och hälsovetenskap Medicine and Health Sciences Nucleosides older Older people People and Places Pharmacology Plasma polypharmacy population Prescription drugs Protease inhibitors Proteinase inhibitors Public health Questionnaires Reviews risk Risk factors Science & Technology - Other Topics survival |
| title | Higher plasma drug levels in elderly people living with HIV treated with darunavir |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-02T14%3A14%3A19IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Higher%20plasma%20drug%20levels%20in%20elderly%20people%20living%20with%20HIV%20treated%20with%20darunavir&rft.jtitle=PloS%20one&rft.au=Tyrberg,%20Erika&rft.date=2021-02-04&rft.volume=16&rft.issue=2&rft.spage=e0246171&rft.pages=e0246171-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0246171&rft_dat=%3Cgale_plos_%3EA650730672%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2486455592&rft_id=info:pmid/33539440&rft_galeid=A650730672&rft_doaj_id=oai_doaj_org_article_2877e860027c415faf296db75c7b26b8&rfr_iscdi=true |