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. doi: 10.1097/01.ftd.0000180225.27008.8c.

Abstract

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. 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. These results may have implications for drug-resistant HIV-1 evolution and transmission.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biological Availability
  • Brazil
  • Cross-Sectional Studies
  • HIV Infections / blood
  • HIV Infections / drug therapy*
  • HIV Infections / virology
  • HIV Protease Inhibitors / blood
  • HIV Protease Inhibitors / pharmacokinetics
  • HIV Protease Inhibitors / therapeutic use
  • HIV-1 / drug effects
  • HIV-1 / growth & development
  • Humans
  • Lopinavir
  • Male
  • Pyrimidinones / blood
  • Pyrimidinones / pharmacokinetics*
  • Pyrimidinones / therapeutic use
  • Regression Analysis
  • Ritonavir / blood
  • Ritonavir / pharmacokinetics*
  • Ritonavir / therapeutic use
  • Semen / chemistry
  • Semen / drug effects
  • Time Factors
  • Urogenital System / drug effects
  • Urogenital System / metabolism*
  • Viral Load

Substances

  • HIV Protease Inhibitors
  • Pyrimidinones
  • Lopinavir
  • Ritonavir