Detrimental clinical interaction between ritonavir-boosted protease inhibitors and vinblastine in HIV-infected patients with Hodgkin's lymphoma

AIDS. 2010 Sep 24;24(15):2408-12. doi: 10.1097/QAD.0b013e32833db989.

Abstract

In order to analyze the clinical relevance of the pharmacokinetic interactions between vinblastine and antiretrovirals described in literature, we evaluated all HIV-infected patients with Hodgkin's lymphoma treated with vinblastine-containing regimens and combination antiretroviral therapy, in a single clinical center. The use of protease inhibitors was independently associated with WHO grade III-IV neutropenia. Moreover, an inverse correlation between dosage of ritonavir and mean nadir neutrophil count was found. The concomitant administration of vinblastine-containing chemotherapy regimens with protease inhibitors can lead to higher levels of neutropenia than those of different classes of drugs such as nonnucleoside reverse transcriptase inhibitors or integrase inhibitors.

MeSH terms

  • Adult
  • Aged
  • Drug Interactions
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • HIV Protease Inhibitors / administration & dosage*
  • HIV Protease Inhibitors / pharmacokinetics
  • Hodgkin Disease / drug therapy*
  • Hodgkin Disease / immunology
  • Humans
  • Male
  • Middle Aged
  • Ritonavir / administration & dosage*
  • Ritonavir / pharmacokinetics
  • Vinblastine / administration & dosage*
  • Vinblastine / pharmacokinetics*

Substances

  • HIV Protease Inhibitors
  • Vinblastine
  • Ritonavir