2022 · JOURNAL OF CHEMOTHERAPY

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

Lagoutte-Renosi, Jennifer, Flammang, Mylene, Ducloux, Didier, Bamoulid, Jamal, Royer, Pierre-Yves, Lepiller, Quentin, Clairet, Anne-Laure, Davani, Siamak, Muret, Patrice

Journal
JOURNAL OF CHEMOTHERAPY
Année
2022
Volume
34
Numéro
3
Pages
199-202
Mois
APR 3
DOI
10.1080/1120009X.2021.1940436

Abstract

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.

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