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International Journal of Tropical Medicine

Pharmacokinetics of Lumefantrine in Adults Co-Infected with Malaria and HIV-1: with and Without Efavirenz-Based Antiretroviral Therapy
David Musoke, Troels K. Bergmann, Muhammad Ntale, Morten Sodemann and Jasper Ogwal-Okeng

Abstract: A parallel study design investigated the pharmacokinetic parameters of lumefantrine in adults co-infected with malaria and HIV-1 in 2 groups enrolled prospectively: Antiretroviral Therapy (ART) naive patients and patients on Efavirenz (EFV)-based therapy. Both groups were on co-Trimoxazole (TS) prophylaxis. Both groups received Artemether-Lumefantrine (AL) combination twice daily for 3 days. Venous blood was collected just before last dose and subsequently at 2, 4, 8, 24 and 120 h post dose. Concentrations of lumefantrine were determined by high performance liquid chromatography. Mean area under the plasma concentration-time curve (AUC0-∞) was 264.8 (243.1-286.5) μg h mL-1, mean maximum Concentration (Cmax) was 4.05 (3.77-4.33) μg mL-1, mean day 7 Concentration (Cday 7) was 0.26 (0.20-0.32) μg mL-1, mean elimination rate (K0) was 0.020933 (0.020219-0.021647) μg h-1 and mean half life was (T1/2) 33.3 (30.9-35.7) h for subjects on EFV-based ART and for ART naive subjects were 375.2 (349.7-400.7) μg h mL-1, 6.08 (5.57-6.59) μg mL-1, 0.64 (0.54-0.74) μg mL-1, 0.0195 (0.0185-0.0205) μg h-1 and 36.0 (34.1-37.9) h, respectively. Time to maximum concentration (Tmax) was 4 h in both groups. EFV based ART significantly decreases the exposure of lumefantrine. AL is well tolerated in these subjects.

How to cite this article
David Musoke, Troels K. Bergmann, Muhammad Ntale, Morten Sodemann and Jasper Ogwal-Okeng, 2012. Pharmacokinetics of Lumefantrine in Adults Co-Infected with Malaria and HIV-1: with and Without Efavirenz-Based Antiretroviral Therapy. International Journal of Tropical Medicine, 7: 187-192.

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