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Effects of guggulsterones-containing thermogenic complex on elvitegravir plasma concentrations: a case report

  • Dario Cattaneo
  • Annalisa Ridolfo
  • Sara Baldelli
  • Cristina GervasoniEmail author
Letter to the Editor
  • 17 Downloads

Combined antiretroviral therapy and care advances have dramatically extended the lifespan of people living with HIV. Patients living longer are enjoying higher level of physical well-being, body care, and beauty, all conditions that are growingly faced with complementary and alternative medicines (CAMs) [1, 2, 3, 4]. Dietary supplements are the most common forms of CAM therapy used; notably, some of these products can cause significant drug-drug interactions (DDIs) with antiretrovirals [5], as confirmed in the present case report.

A 45-year-old homosexual man was diagnosed with HIV infection in February 2018 (HIV RNA 147,000 copies/mL, CD4+ cell count 47 cells/mm 3). After the diagnosis, he started immediately antiretroviral therapy with a fixed dose combination of elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide. At the second visit, done in March 2018, the patient showed a rapid decline in the HIV RNA (83 copies/mL) associated with a partial recovery of CD4+ cell count...

Notes

Authors’ contribution

DC and CG supervised all the stages of the study and wrote the first draft of the manuscript. SB performed pharmacokinetic analyses and revised the draft manuscript. AR took care of the patient.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Ball SC (2014) Increased longevity in HIV: caring for older HIV-infected adults. Care Manag J 15:76–82CrossRefGoogle Scholar
  2. 2.
    Moore RC, Fazeli PL, Jeste DV, Moore DJ, Grant I, Woods SP et al (2014) Successful cognitive aging and health-related quality of life in younger and older adults infected with HIV. AIDS Behav 18:1186–1197CrossRefGoogle Scholar
  3. 3.
    Halpin SN, Carruth EC, Rai RP, Jennifer Edelman E, Fiellin DA, Gibert C, Gordon KS, Huang W, Justice A, Marconi VC, Rimland D, Perkins MM (2018) Complementary and alternative medicine among persons living with HIV in the era of combined antiretroviral treatment. AIDS Behav 22:848–852CrossRefGoogle Scholar
  4. 4.
    Lorenc A, Robinson N (2013) A review of the use of complementary and alternative medicine and HIV: issues for patient care. AIDS Patient Care STDs 27:503–510CrossRefGoogle Scholar
  5. 5.
    Jalloh MA, Gregory PJ, Hein D, Risoldi Cochrane Z, Rodriguez A (2017) Dietary supplement interactions with antiretrovirals: a systematic review. Int J STD AIDS 28:4–15CrossRefGoogle Scholar
  6. 6.
    Elliot E, Chirwa M, Boffito M (2017) How recent findings on the pharmacokinetics and pharmacodynamics of integrase inhibitors can inform clinical use. Curr Opin Infect Dis 30:58–73Google Scholar
  7. 7.
    Yamada T, Sugimoto K (2016) Guggulsterone and its role in chronic diseases. Adv Exp Med Biol 929:329–361CrossRefGoogle Scholar
  8. 8.
    Brobst DE, Ding X, Creech KL, Goodwin B, Kelley B, Staudinger JL (2004) Guggulsterone activates multiple nuclear receptors and induces CYP3A gene expression through the pregnane X receptor. J Pharmacol Exp Ther 310:528–535CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Gestione Ambulatoriale Politerapie (GAP) outpatient clinicASST Fatebenefratelli Sacco University HospitalMilanItaly
  2. 2.Unit of Clinical PharmacologyASST Fatebenefratelli Sacco University HospitalMilanItaly
  3. 3.Department of Infectious DiseasesASST Fatebenefratelli Sacco University HospitalMilanItaly

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