Crushed dolutegravir/abacavir/lamivudine given via nasogastric tube in gastric outlet obstruction caused by cancer resulted in rapid viral load suppression

International Journal of STD & AIDS
Aleš ChrdleVáclav Chmelík

Abstract

Alternative modes of antiretroviral administration are sought for people with impaired intestinal passage and/or absorption. We present a case of late HIV diagnosis (CD4+ count 160 cells/µL) with gastric outlet obstruction due to stomach adenocarcinoma. Co-morbidities included oesophageal candidiasis, Helicobacter pylori-positive duodenal ulcers and cytomegalovirus duodenitis. The gastric outlet obstruction required total parenteral nutrition and parenteral medication during four weeks of diagnostic work-up leading to pyloric resection. Crushed dolutegravir, abacavir and lamivudine were administered during this time in the evening via nasogastric tube, which was kept clamped overnight. The tube was unclamped in the morning and stomach content was drained during the daytime. This mode of administration resulted in rapid and sustained viral load suppression (from 300,000 to 115 copies per mL in 28 days, 81 copies/mL after 42 days of treatment and less than 40 copies/mL thereafter). Therapeutic drug monitoring confirmed sufficient antiretroviral plasma levels during this mode of administration. The absorption of crushed dolutegravir, abacavir and lamivudine in the stomach may be considered in people with questionable gastrointesti...Continue Reading

References

May 16, 2008·Clinical Pharmacokinetics·Geoffrey J YuenGary E Pakes
Dec 1, 2010·Antimicrobial Agents and Chemotherapy·Masanori KobayashiTamio Fujiwara
May 7, 2014·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Stephen WellerStephen C Piscitelli
Jul 22, 2016·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Lindsey Buscemi
Feb 16, 2017·Journal of the International Association of Providers of AIDS Care·Sarah Lynn Turley, Patricia Pecora Fulco

❮ Previous
Next ❯

Citations

Mar 25, 2020·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Patricia Pecora Fulco
Feb 6, 2020·Therapeutic Advances in Infectious Disease·James CutrellRoger Bedimo
Dec 30, 2020·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Joseph I Boullata

❮ Previous
Next ❯

Related Concepts

Related Feeds

HIV/AIDS-Related Malignancies

HIV/AIDS infection increases the risk of non-communicable diseases common in the aged including HIV/AIDS-related malignancies. Discover the latest research in HIV/AIDS-related malignancies.

Candida albicans

Candida albicans is an opportunistic, fungal pathogen of humans that frequently causes superficial infections of oral and vaginal mucosal surfaces of debilitated and susceptible individuals. Discover the latest research on Candida albicans here.

Candidiasis

Candidiasis is a common fungal infection caused by Candida and it can affect many parts for the body including mucosal membranes as well as the gastrointestinal, urinary, and respiratory tracts. Here is the latest research.

Candidiasis (ASM)

Candidiasis is a common fungal infection caused by Candida and it can affect many parts for the body including mucosal membranes as well as the gastrointestinal, urinary, and respiratory tracts. Here is the latest research.

Related Papers

Nutrición hospitalaria
J M Moreno VillaresM León Sanz
British Journal of Clinical Pharmacology
L F Prescott
Antibiotiki i meditsinskaia biotekhnologiia = Antibiotics and medical biotechnology
L Z SkalaV P Iakovlev
© 2022 Meta ULC. All rights reserved