Efavirenz in an obese HIV-infected patient--a report and an in vitro-in vivo extrapolation model indicate risk of underdosing

Mirjam de Roche; Marco Siccardi; Marcel Stoeckle; Françoise Livio; David Back; Manuel Battegay; Catia Marzolini

doi:10.3851/IMP2107

Efavirenz in an obese HIV-infected patient--a report and an in vitro-in vivo extrapolation model indicate risk of underdosing

Antivir Ther. 2012;17(7):1381-4. doi: 10.3851/IMP2107. Epub 2012 Apr 24.

Authors

Mirjam de Roche¹, Marco Siccardi, Marcel Stoeckle, Françoise Livio, David Back, Manuel Battegay, Catia Marzolini

Affiliation

¹ Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.

PMID: 22910127
DOI: 10.3851/IMP2107

Abstract

Here, we report suboptimal efavirenz exposure in an obese patient treated with the standard 600 mg dose. Tripling the dose allowed attainment of therapeutic efavirenz concentrations. We developed an in vitro-in vivo extrapolation model to quantify dose requirements in obese individuals. Obesity represents a risk factor for antiretroviral therapy underdosing.

Publication types

Case Reports

MeSH terms

Alkynes
Benzoxazines / administration & dosage*
Benzoxazines / pharmacokinetics
Body Mass Index
Computer Simulation
Cyclopropanes
Drug Dosage Calculations
Drug Monitoring / methods
HIV / pathogenicity
HIV Infections / drug therapy*
HIV Infections / pathology
HIV Infections / virology
Humans
Male
Middle Aged
Obesity / pathology*
RNA, Viral / blood
Reverse Transcriptase Inhibitors / administration & dosage
Reverse Transcriptase Inhibitors / pharmacokinetics
Risk Factors
Viral Load

Substances

Alkynes
Benzoxazines
Cyclopropanes
RNA, Viral
Reverse Transcriptase Inhibitors
efavirenz