Antiretroviral Therapy Pharmacokinetic Considerations in Patients with Renal or Hepatic Impairment

• Published in: Clinical pharmacokinetics Vol. 47; no. 3; pp. 153 - 172
• Main Authors: McCabe, Sarah M., Ma, Qing, Slish, Judianne C., Catanzaro, Linda M., Sheth, Neha, DiCenzo, Robert, Morse, Gene D.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.01.2008; Adis international; Wolters Kluwer Health, Inc
• Subjects: Anti-HIV Agents - administration & dosage; Anti-HIV Agents - adverse effects; Anti-HIV Agents - pharmacokinetics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiretroviral Therapy, Highly Active; Antiviral agents; Biological and medical sciences; Drug Monitoring; Gastroenterology. Liver. Pancreas. Abdomen; HIV Infections - complications; HIV Infections - drug therapy; Humans; Internal Medicine; Kidney Diseases - complications; Liver Diseases - complications; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Medical sciences; Medicine; Medicine & Public Health; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Other diseases. Semiology; Pharmacology. Drug treatments; Pharmacology/Toxicology; Pharmacotherapy; Protein Binding; Renal failure; Review Article; Tenofovir; Atazanavir; Hepatic Impairment; Indinavir; Nelfinavir; Kidney disease; Human; Antiretroviral agent; Urinary system disease; Hepatic disease; Review; Liver failure; Nephropathy; Treatment; Renal failure; Digestive diseases; Antiviral; Pharmacokinetics
• ISSN: 0312-5963; 1179-1926
• DOI: 10.2165/00003088-200847030-00002

Hepatic and renal insufficiency due to co-infection, alcoholism, diabetes mellitus, family history, adverse effects of antiretrovirals and other factors are commonly seen in HIV-infected patients. Therefore, the use of antiretrovirals in this patient setting requires attention to the pharmacokinetic issues that clinicians must consider when prescribing highly active antiretroviral therapy for these patients. This review summarizes the current knowledge of the use of antiretrovirals in patients with hepatic or renal impairment, and makes dosing recommendations for this subpopulation of HIV-infected patients.