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Cusato J, Manca A, Palermiti A, Mula J, Antonucci M, Chiara F, De Nicolò A, Lupia T, Stroffolini G, Boglione L, D'Avolio A. Pharmacogenetics of tenofovir drug transporters in the context of HBV: Is there an impact? Biomed Pharmacother 2024; 175:116678. [PMID: 38713940 DOI: 10.1016/j.biopha.2024.116678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/19/2024] [Accepted: 04/29/2024] [Indexed: 05/09/2024] Open
Abstract
BACKGROUND Current treatments for chronic hepatitis B management include orally administered nucleos(t)ide analogues, such as tenofovir (TDF), which is an acyclic adenine nucleotide analogue used both in HBV and human immune deficiency virus (HIV). The course of HBV infection is mainly dependent on viral factors, such as HBV genotypes, immunological features and host genetic variables, but a few data are available in the context of HBV, in particular for polymorphisms of genes encoding proteins involved in drug metabolism and elimination. Consequently, the aim of this study was to evaluate the potential impact of genetic variants on TDF plasma and urine concentrations in patients with HBV, considering the role of HBV genotypes. METHODS A retrospective cohort study at the Infectious Disease Unit of Amedeo di Savoia Hospital, Torino, Italy, was performed. Pharmacokinetic analyses were performed through liquidi chromatography, whereas pharmacogenetic analyses through real-time PCR. FINDINGS Sixty - eight patients were analyzed: ABCC4 4976 C>T genetic variant showed an impact on urine TDF drug concentrations (p = 0.014). In addition, SLC22A6 453 AA was retained in the final regression multivariate model considering factors predicting plasma concentrations, while ABCC4 4976 TC/CC was the only predictor of urine concentrations in the univariate model. INTERPRETATION In conclusion, this is the first study showing a potential impact of genetic variants on TDF plasma and urine concentrations in the HBV context, but further studies in different and larger cohorts of patients are required.
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Affiliation(s)
- J Cusato
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, Turin 10149, Italy
| | - A Manca
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, Turin 10149, Italy
| | - A Palermiti
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, Turin 10149, Italy.
| | - J Mula
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, Turin 10149, Italy.
| | - M Antonucci
- Amedeo di Savoia Hospital, ASL Città di Torino, Turin, Italy
| | - F Chiara
- University of Turin, Department of Clinical and Biological Sciences, Laboratory of Clinical Pharmacology San Luigi A.O.U., Orbassano, TO, Italy
| | - A De Nicolò
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, Turin 10149, Italy
| | - Tommaso Lupia
- Department of Medical Sciences, Infectious Diseases, University of Turin, Italy
| | - Giacomo Stroffolini
- Department of Medical Sciences, Infectious Diseases, University of Turin, Italy
| | - L Boglione
- University of Eastern Piedmont, Department of Translational Medicine, Novara, Italy
| | - A D'Avolio
- Laboratory of Clinical Pharmacology and Pharmacogenetics, Department of Medical Sciences, University of Turin, Amedeo di Savoia Hospital, Corso Svizzera, 164, Turin 10149, Italy
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Bertrand J, Barrail-Tran A, Fayette L, Savic R, Goujard C, Teicher E, Barau C, Pruvost A, Taburet AM, Mentré F, Verstuyft C. Pharmacokinetic Model of Tenofovir and Emtricitabine and Their Intracellular Metabolites in Patients in the ANRS 134-COPHAR 3 Trial Using Dose Records. Antimicrob Agents Chemother 2023; 67:e0233918. [PMID: 37098914 PMCID: PMC10190280 DOI: 10.1128/aac.02339-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 03/22/2023] [Indexed: 04/27/2023] Open
Abstract
Tenofovir (TFV) and emtricitabine (FTC) are part of the recommended highly active antiretroviral therapy (ART). Both molecules show a large interindividual pharmacokinetic (PK) variability. Here, we modeled the concentrations of plasma TFV and FTC and their intracellular metabolites (TFV diphosphate [TFV-DP] and FTC triphosphate [FTC-TP]) collected after 4 and 24 weeks of treatment in 34 patients from the ANRS 134-COPHAR 3 trial. These patients received daily (QD) atazanavir (300 mg), ritonavir (100 mg), and a fixed-dose combination of coformulated TFV disoproxil fumarate (300 mg) and FTC (200 mg). Dosing history was collected using a medication event monitoring system. A three-compartment model with absorption delay (Tlag) was selected to describe the PK of, respectively, TFV/TFV-DP and FTC/FTC-TP. TFV and FTC apparent clearances, 114 L/h (relative standard error [RSE] = 8%) and 18.1 L/h (RSE = 5%), respectively, were found to decrease with age. However, no significant association was found with the polymorphisms ABCC2 rs717620, ABCC4 rs1751034, and ABCB1 rs1045642. The model allows prediction of TFV-DP and FTC-TP concentrations at steady state with alternative regimens.
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Affiliation(s)
- Julie Bertrand
- UMR 1137, IAME, INSERM, Université Paris Cité, Paris, France
| | - Aurélie Barrail-Tran
- AP-HP, Hôpital Bicêtre, Pharmacie Clinique, Le Kremlin-Bicêtre, France
- UMR 1184, Center for Immunology of Viral Infections and Autoimmune Diseases, INSERM, Université Paris Sud, Paris, France
| | - Lucie Fayette
- UMR 1137, IAME, INSERM, Université Paris Cité, Paris, France
| | - Rada Savic
- Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, California, USA
| | - Cécile Goujard
- AP-HP, Hôpital Bicêtre, Service de médecine interne et d’immunologie clinique, Le Kremlin-Bicêtre, France
- CESP, Team Epidémiologie Clinique, INSERM UMR 1018, Faculté de Médecine, Univ Paris-Saclay, Le Kremlin Bicêtre, France
| | - Elina Teicher
- AP-HP, Hôpital Bicêtre, Service de médecine interne et d’immunologie clinique, Le Kremlin-Bicêtre, France
| | - Caroline Barau
- AP-HP, Hôpital Henri Mondor, Plateforme de Ressources Biologiques, Créteil, France
| | - Alain Pruvost
- Département Médicaments et Technologies pour la Santé, SPI, CEA, INRAE, Université Paris Saclay, Paris, France
| | - Anne-Marie Taburet
- AP-HP, Hôpital Bicêtre, Pharmacie Clinique, Le Kremlin-Bicêtre, France
- UMR 1184, Center for Immunology of Viral Infections and Autoimmune Diseases, INSERM, Université Paris Sud, Paris, France
| | - France Mentré
- UMR 1137, IAME, INSERM, Université Paris Cité, Paris, France
| | - Céline Verstuyft
- CESP, Team Epidémiologie Clinique, INSERM UMR 1018, Faculté de Médecine, Univ Paris-Saclay, Le Kremlin Bicêtre, France
- AP-HP, Hôpital Bicêtre, Service de génétique moléculaire et pharmacogénétique, Le Kremlin-Bicêtre, France
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Solanke T, Kamau F, Esterhuizen T, Maartens G, Khoo S, Joska JA, Kellermann T, Strijdom H, Decloedt EH. Concentrations of Efavirenz, Tenofovir, and Emtricitabine in Obesity: A Cross-Sectional Study. J Acquir Immune Defic Syndr 2022; 91:101-108. [PMID: 35972856 DOI: 10.1097/qai.0000000000003025] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 05/16/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Obesity is increasing worldwide including in people living with HIV (PLWH). Antiretroviral pharmacokinetic data in obesity are limited. OBJECTIVES To measure antiretroviral drug concentrations in obese and nonobese PLWH treated with the fixed-dose combination of efavirenz-tenofovir-emtricitabine. To determine pharmacokinetic differences across indicators of obesity and their associated immunovirological outcomes. METHODS We conducted a cross-sectional sample analysis of 2 cohort studies. We measured mid-dose efavirenz, 8-hydroxy-efavirenz, tenofovir, and emtricitabine concentrations. Antiretroviral drug concentrations were analyzed by body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR). RESULTS We performed a study of 213 participants: General obesity was detected in 20.4% using BMI and abdominal obesity in 53.6% using WC and 62.4% using WHR, respectively. The median concentrations of all antiretroviral drugs were lower among obese participants determined by BMI and WC, with efavirenz showing greater differences than tenofovir or emtricitabine. For BMI, results were most striking for efavirenz (1752.3 vs 2342.9 ng/mL, P = 0.002) with lower concentrations in obese participants. Using WC, efavirenz (1845.8 vs 2571.2 ng/mL, P < 0.001), tenofovir (65.8 vs 73.2 ng/mL, P = 0.036), and emtricitabine (159.5 vs 221.0 ng/mL, P = 0.005) concentrations were lower in obese participants. Eight-hydroxyefavirenz concentrations were similar in nonobese and obese participants for WC. Using WHR, the concentrations of all antiretroviral drugs were lower in the obese population, most strikingly for emtricitabine (173.5 vs 229.0 ng/mL, P = 0.015). There were no immunovirological associations. CONCLUSION We found lower antiretroviral concentrations in all obese groups, most strikingly in participants with abdominal obesity determined by WC. Lower drug concentrations had no immunovirological associations.
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Affiliation(s)
- Toyosi Solanke
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Festus Kamau
- Division of Medical Physiology, Department of Biomedical Sciences, Centre for Cardio-metabolic Research in Africa (CARMA), Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Tonya Esterhuizen
- Division of Epidemiology and Biostatistics, Department of Global Health, Biostatistics Unit, Stellenbosch University, Cape Town, South Africa
| | - Gary Maartens
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, South Africa
| | - Saye Khoo
- Department of Molecular and Clinical Pharmacology, University of Liverpool; and
| | - John A Joska
- HIV Mental Health Research Unit, Division of Neuropsychiatry, Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Tracy Kellermann
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Hans Strijdom
- Division of Medical Physiology, Department of Biomedical Sciences, Centre for Cardio-metabolic Research in Africa (CARMA), Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Eric H Decloedt
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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