Pharmacokinetics and Safety of Ainuovirine/Lamivudine/Tenofovir Combination Tablets in Young and Elderly Patients with Human Immunodeficiency Virus-1 Infection

阿诺韦林/拉米夫定/替诺福韦复方片剂在感染人类免疫缺陷病毒-1的年轻和老年患者中的药代动力学和安全性

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Abstract

INTRODUCTION: Ainuovirine/lamivudine/tenofovir is a novel antiretroviral therapy regimen used to treat human immunodeficiency virus-1 (HIV-1) infection. This study aimed to compare the pharmacokinetics of ainuovirine/lamivudine/tenofovir in HIV-1-infected patients aged ≥ 65 (elderly patients) and ≤ 40 years (young patients). METHODS: This prospective, open-label, parallel controlled clinical study included 15 young and 15 elderly patients. Blood (1 mL) was collected 30 min before dosing and at 0.5, 1, 1.5, 2, 3, 4, 8, 12, 16, and 24 h after dosing, to measure the plasma concentrations of ainuovirine/lamivudine/tenofovir. Safety was assessed by monitoring the adverse events, physical examinations, and clinical laboratory tests. RESULTS: Plasma concentrations of each ainuovirine/lamivudine/tenofovir component reached peak levels 1-4 h after dosing and gradually decreased during the remaining observation period. Compared with the young group, ainuovirine had significantly higher T(1/2Ke), AUC(0-24), and AUC(0-inf) (all P < 0.05) in the elderly group, whereas K(e) (P = 0.002) was significantly lower. However, the C(max) and T(max) of ainuovirine did not differ significantly. Lamivudine and tenofovir also had a significantly higher C(max) (p = 0.004 and p = 0.008, respectively) and AUC(0-inf) (P = 0.014 and P = 0.006, respectively) in the elderly group, whereas there was no significant difference in T(max), K(e), and T(1/2Ke). Ainuovirine/lamivudine/tenofovir was well tolerated in both the young and elderly groups. CONCLUSION: This study suggests that the ainuovirine/lamivudine/tenofovir regimen might be an effective and safe treatment regimen for HIV-1-infected patients aged ≥ 65 years and ≤ 40 years. Further studies are needed to confirm these results and develop optimal dosing regimens for elderly HIV-1-infected patients.

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