by Kip AE, Blesson S, Alves F, Wasunna M, Kimutai R, Menza P, Mengesha B, Beijnen JH, Hailu A, Diro E, Dorlo TPC. Journal of Antimicrobial Chemotherapy 2021, doi: 10.1093/jac/dkab013.
Summary: The adequacy of antileishmanial drug exposure and the effect of HIV-VL co-morbidity on the pharmacokinetics of antileishmanial and antiretroviral (ARV) drugs in Ethiopian patients is unknown. In this study, the authors describe the pharmacokinetics of concomitantly administered antileishmanial and ARV drugs. PK samples were collected in a clinical trial in Ethiopia investigating the safety and efficacy of liposomal amphotericin B in monotherapy or in combination with miltefosine in the treatment of HIV co-infected visceral leishmaniasis patients. Both amphotericin B and miltefosine exposures were lower than previously observed in non-visceral leishmaniasis and non-HIV-VL patients, respectively. Pharmacokinetic and dose finding studies of co-administered antileishmanial and ARV drugs to ensure adequate exposure is especially important in these vulnerable patients, given the high proportion of relapses.