Marked increase in etravirine and saquinavir plasma concentrations during atovaquone/proguanil prophylaxis
1 "National Institute for Infectious Diseases "L. Spallanzani", Via Portuense 292, 00149 Rome, Italy
2 Clinica Universitaria c/o Ospedale Amedeo di Savoia, University of Turin, Turin - Italy
Malaria Journal 2011, 10:141 doi:10.1186/1475-2875-10-141Published: 21 May 2011
The case of a 32-year-old Caucasian female with multi-drug resistant HIV-1 subtype B infection treated with a salvage regimen including maraviroc, raltegravir, etravirine and unboosted saquinavir who started atovaquone/proguanil prophylaxis, is reported. The potential interactions between atovaquone/proguanil and these anti-retroviral drugs are investigated. Pharmacokinetic analyses documented a marked increase in etravirine and saquinavir plasma concentrations (+55% and +274%, respectively), but not in raltegravir and maraviroc plasma concentrations. The evidence that atovaquone/proguanil significantly interacts with etravirine and saquinavir, but not with raltegravir and maraviroc, suggests that the mechanism of interaction is related to cytochrome P450.