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

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...


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.


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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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