Subject(s)
Cat's Claw , HIV Protease Inhibitors , Herb-Drug Interactions , Plant Preparations , Atazanavir Sulfate , Cat's Claw/adverse effects , Female , HIV Protease Inhibitors/administration & dosage , HIV Protease Inhibitors/blood , HIV Protease Inhibitors/pharmacokinetics , HIV Protease Inhibitors/therapeutic use , Humans , Metabolic Clearance Rate , Middle Aged , Oligopeptides/administration & dosage , Oligopeptides/blood , Oligopeptides/pharmacokinetics , Oligopeptides/therapeutic use , Plant Preparations/administration & dosage , Plant Preparations/adverse effects , Pyridines/administration & dosage , Pyridines/blood , Pyridines/pharmacokinetics , Pyridines/therapeutic use , Ritonavir/administration & dosage , Ritonavir/blood , Ritonavir/pharmacokinetics , Ritonavir/therapeutic use , Saquinavir/administration & dosage , Saquinavir/blood , Saquinavir/pharmacokinetics , Saquinavir/therapeutic useABSTRACT
La incorporación de los inhibidores de la proteasa (saquinavir, ritonavir, indinavir, nelfinavir) en la terapia antirretroviral ha supuesto un importante descenso en la morbilidad y mortalidad provocada por el SIDA. Son compuestos no peptídicos que inhiben de forma potente y selectiva la proteasa del VIH-1. Se caracterizan por tener en común un metabolismo de eliminación hepático y una semivida de eliminación corta, con diferencias en el ámbito de absorción y distribución. Excepto el indinavir, deben administrarse con comidas. Poseen distintos perfiles de toxicidad, siendo el ritonavir el que presenta una mayor incidencia de reacciones adversas. La extensa metabolización por la isoenzima CYP3A4 del citocromo P450 puede originar interacciones de interés clínico. Actualmente, la carga viral y linfocitos T CD4 son los marcadores de evolución clínica de la enfermedad. Recientes estudios sugieren que la monitorización de las concentraciones plasmáticas pueden ser de utilidad en casos de no-adherencia, interacciones farmacocinéticas y fracaso virológico (AU)
Subject(s)
Humans , Antiviral Agents/therapeutic use , Antiviral Agents/pharmacokinetics , HIV Infections/drug therapy , HIV Infections/blood , Protease Inhibitors/therapeutic use , Protease Inhibitors/pharmacokinetics , Protease Inhibitors/adverse effectsABSTRACT
A cross-sectional study was designed to determine whether plasma concentrations of glutathione and cysteine in HIV-infected hemophiliacs vary according to the progression of the disease and to compare them with those obtained in HIV negative hemophiliacs. Cysteine, total glutathione and glutathione disulphide were measured in plasma of HIV-infected hemophiliacs at different stages of HIV infection and in plasma of HIV-negative hemophiliacs. CD4 and CD8 T-cell counts, leukocyte and lymphocyte counts, beta 2-microglobulin and p24 antigen values were recorded for HIV positive hemophiliacs at the time of the study. The hemophiliac HIV-positive group showed a decrease in total glutathione levels (-18%) and an increase of glutathione disulphide (8.18 vs. 14.90%) compared to the HIV-negative group. The cysteine levels found in HIV-positive hemophiliacs were not different from those found in the HIV-negative group. There were no differences with statistical significance in total glutathione, glutathione disulphide and cysteine among HIV-infected hemophiliacs according to the different clinical stage of the disease (AIDS vs. non-AIDS). The interest of evaluating plasma concentrations of glutathione and cysteine in HIV-infected patients is limited from the point of view of considering them as markers of progression of the disease. Interest in a therapeutic strategy designed to replenish or normalize glutathione plasma levels is also limited.
