Pharmacokinetic profiles of boosted darunavir, dolutegravir and lamivudine in aging patients enrolled in the Swiss HIV Cohort Study. AIDS
Courlet et al. aimed to compare boosted darunavir, dolutegravir, and lamivudine plasma exposures between aging (≥ 65 years) and younger (< 65 years) people living with HIV (PLWH) involved in two observational studies to better document pharmacokinetics (PK) of antiretroviral drugs (ARVs) in this growing vulnerable population.
Nineteen PLWH with a median age of 64 participated to the full PK investigations. Single point PK data were collected for 804 PLWH with a median age of 52. Boosted darunavir clearance was 40% lower in aging (≥ 65 years) compared to younger (< 65 years) PLWH, consistent with other drugs predominantly metabolized by CYP3A. Dolutegravir exposure was similar between age groups whereas lamivudine exposure increased by 11% in aging PLWH. Median boosted darunavir, dolutegravir and lamivudine t1/2 were 148%, 45% and 32% higher in aging compared to younger PLWH.
In conclusion, boosted darunavir exposure was highly variable but modestly increased in aging PLWH. Dolutegravir and lamivudine exposure was minimally affected by age. Thus, dose adjustment based on age is a priori not warranted. Nevertheless, there is still a need for studies to allow a better understanding of ARVs PK in this vulnerable growing population.
Additional comment PD Dr. Dominique Braun and Prof. Huldrych Günthard
With this 56th press release in 2019, we say good-bye to you and wish you and your families a merry Christmas and a happy New Year. We hope that you will read us again in 2020 and that we can continue to provide you interesting results from the SHCS research community.