HIV/AIDS HAART: Lopinavir and ritonavir have limited penetration in the male genital tract

AIDSWEEKLY Plus; Monday, June 19, 2006
Staff Medical Writers

"The concentrations of lopinavir and ritonavir in seminal and blood plasma and the seminal human immunodeficiency virus (HIV) viral load were quantified by HPLC and the Nuclisens assay, respectively, in a cross-sectional study of 16 HIV-1-infected Brazilian men under stable treatment with a lopinavir/ritonavir containing antiretroviral regimen.

"Semen and blood samples were collected on 2 occasions: at 6 to 60 minutes before ('trough'), and 5 to 6 hours after ('peak') ingestion of regular doses of lopinavir/ritonavir," wrote investigators in Brazil.

According to T.R. Vergara and colleagues at the Universidade Federal do Rio de Janeiro, "Median seminal lopinavir levels were 120.6 ng/mL (range, <20-1481.8 ng/mL) and 233.1 ng/mL (range, 48.4-1133.4 ng/mL) at trough and peak points, respectively.

"The corresponding values for ritonavir were 9.2 ng/mL (range, <5-47 ng/mL) and 17.1 ng/mL (range, 6.6-66.7 ng/mL)."

"The median concentrations of lopinavir and ritonavir in semen were, respectively, 1.9 to 3% and 3.7 to 4.4% of those measured in blood plasma samples collected within 30 minutes. HIV-1 viral load was detectable in the semen of 2 and in the blood of 6 of 16 patients," researchers said.

Vergara concluded, "These results may have implications for drug-resistant HIV-1 evolution and transmission."

Vergara and colleagues published their study in Therapeutic Drug Monitoring (Limited penetration of lopinavir and ritonavir in the genital tract of men infected with HIV-1 in Brazil. Ther Drug Monit. 2006 Apr;28(2):175-9).

For additional information, contact P.F. Barroso, University of Fed Rio de Janeiro, Hospital University of Clementino Fraga Filho, Infectious Disease Service, Avenue Brigadeiro Trompowski S-N, Ilha Fundao, BR-21941590 Rio de Janeiro, Brazil.

The publisher's contact information for the journal Therapeutic Drug Monitoring is: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA.

Keywords: Rio de Janeiro, Brazil, HIV/AIDS, Lopinavir & Ritonavir, Seminal Plasma Viral Load, Plasma Viral Load, Semen Drug Level.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Vergara TR, Estrela RC, Suarez-Kurtz G, et al., "Limited penetration of lopinavir and ritonavir in the genital tract of men infected with HIV-1 in Brazil", Ther Drug Monit. 2006 Apr;28(2):175-9.

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