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

Fiche publication

Date publication

juin 2021

Journal

Journal of chemotherapy (Florence, Italy)

Auteurs

Membres identifiés du Cancéropôle Est :
Pr DUCLOUX Didier

Tous les auteurs :
Lagoutte-Renosi J, Flammang M, Ducloux D, Bamoulid J, Royer PY, Lepiller Q, Clairet AL, Davani S, Muret P

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/34180378

Résumé

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.