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Inflammation and pharmacokinetics: potential implications for HIV-infection
Sharon M Seifert1, Jose R Castillo-Mancilla2, Kristine M Erlandson2
1a Skaggs School of Pharmacy and Pharmaceutical Sciences Department of Pharmaceutical Sciences , University of Colorado , Anschutz Medical Campus, USA.
Expert Opinion on Drug Metabolism & Toxicology
|March 25, 2017
Summary
Inflammation can change how the body processes drugs, affecting HIV patients on antiretroviral therapy (ART). Further research is needed to understand these pharmacokinetic changes and personalize medication dosages.
Area of Science:
- Pharmacokinetics
- HIV Medicine
- Inflammation Biology
Background:
- Physiological changes during inflammation can alter drug pharmacokinetics (PK).
- HIV-infected individuals often have chronic inflammation despite effective antiretroviral therapy (ART).
- Age-related inflammation is also prevalent in the aging HIV population.
Purpose of the Study:
- To review current knowledge on inflammation-altered PK.
- To assess the implications for HIV pharmacotherapy.
- To identify research gaps and future directions.
Main Methods:
- Extensive literature search using PubMed and bibliographies.
- Synthesis of preclinical and clinical study findings.
- Expert opinion integration.
Main Results:
- Inflammation downregulates drug-metabolizing enzymes.
- Transporter expression is variably affected by inflammation.
- Gastric acidity, fluid shifts, and plasma protein changes impact drug absorption, distribution, and clearance.
Conclusions:
- Inflammation significantly alters drug PK, with clinical relevance needing further investigation.
- Controlled PK studies are crucial, particularly in aging HIV-infected individuals.
- Understanding these interactions will enable personalized pharmacotherapy.
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