Bictegravir/emtricitabine/tenofovir alafenamide combination in the management of kidney transplant patients with HIV receiving immunosuppressants

We report here a drug-drug interaction with tacrolimus in a HIV-positive patient with renal transplant, after switch from highly active antiretroviral therapy with boosted protease inhibitors to the combination bictegravir/emtricitabine/tenofovir alafenamide. Although the tacrolimus doses were adapt...

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Bibliographic Details
Published in:Journal of chemotherapy (Florence) 2022-05, Vol.34 (3), p.199-202
Main Authors: Lagoutte-Renosi, Jennifer, Flammang, Mylène, Ducloux, Didier, Bamoulid, Jamal, Royer, Pierre-Yves, Lepiller, Quentin, Clairet, Anne-Laure, Davani, Siamak, Muret, Patrice
Format: Article
Language:English
Subjects:
Adenine
Alanine
Amides
Anti-HIV Agents - therapeutic use
Drug Combinations
Emtricitabine - therapeutic use
Heterocyclic Compounds, 3-Ring
Heterocyclic Compounds, 4 or More Rings - therapeutic use
HIV Infections - drug therapy
Humans
Immunosuppressive Agents - therapeutic use
Kidney Transplantation
Piperazines
Protease Inhibitors - therapeutic use
Pyridones
Tacrolimus - therapeutic use
Tenofovir - analogs & derivatives
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Summary:We report here a drug-drug interaction with tacrolimus in a HIV-positive patient with renal transplant, after switch from highly active antiretroviral therapy with boosted protease inhibitors to the combination bictegravir/emtricitabine/tenofovir alafenamide. Although the tacrolimus doses were adapted to take account of the pharmacokinetic interactions with protease inhibitors, a tacrolimus overdosage occurred in the patient nonetheless. Through this case report, we highlight the need to consider a sufficient timeframe of withdrawal of protease inhibitors, which induce a prolonged drug-drug interaction with tacrolimus. To conclude, we purport that the combination bictegravir/emtricitabine/tenofovir alafenamide could be an attractive alternative in the context of transplantation provided a discontinuation of boosted protease inhibitors for more than 48 hours before introducing tacrolimus.
ISSN:1120-009X
1973-9478
DOI:10.1080/1120009X.2021.1940436