{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T21:16:58Z","timestamp":1778275018330,"version":"3.51.4"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2017,7,18]],"date-time":"2017-07-18T00:00:00Z","timestamp":1500336000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:p>The use of enteral feeding tubes to administer antiretroviral medications is necessary in certain patients with human immunodeficiency virus (<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>) infection. However, adequacy of drug exposures after these administration routes are largely unknown, making dosing recommendations and the attainment of viral suppression challenging in this patient population. This report describes a patient with advanced <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> infection and a complicated medical history including long\u2010term intractable nausea\/vomiting necessitating antiretroviral medication administration via a Roux\u2010en\u2010Y jejunostomy (J)\u2010tube. Pharmacokinetic assessments were performed to compare differences in antiretroviral drug absorption and plasma exposure following oral and J\u2010tube administration of dolutegravir, tenofovir disoproxil fumarate, and emtricitabine. Results were also compared with published pharmacokinetic data in <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected individuals. Exposure to dolutegravir and tenofovir were similar between J\u2010tube and oral administration routes, whereas emtricitabine exposure was 38% lower when administered via J\u2010tube. However, in comparison with reference data in <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected individuals taking these medications orally, exposure to dolutegravir and tenofovir was 75\u201376% and 55\u201361% lower, respectively, following both routes of administration. Emtricitabine exposure was similar to and 71% higher than reference data following J\u2010tube and oral administration, respectively. This report highlights the importance of performing pharmacokinetic assessments in patients with the potential for impaired drug absorption to ensure antiretroviral treatment success.<\/jats:p>","DOI":"10.1002\/phar.1960","type":"journal-article","created":{"date-parts":[[2017,5,27]],"date-time":"2017-05-27T03:47:34Z","timestamp":1495856854000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Decreased Absorption of Dolutegravir and Tenofovir Disoproxil Fumarate, But Not Emtricitabine, in an <scp>HIV<\/scp>\u2010Infected Patient Following Oral and Jejunostomy\u2010Tube Administration"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3832-8699","authenticated-orcid":false,"given":"Kristina M.","family":"Brooks","sequence":"first","affiliation":[{"name":"Clinical Pharmacokinetics Research Unit, Clinical Center Pharmacy Department National Institutes of Health (NIH) Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katy L.","family":"Garrett","sequence":"additional","affiliation":[{"name":"Division of Pharmacotherapy and Experimental Therapeutics University of North Carolina at Chapel Hill\u2010Eshelman School of Pharmacy Chapel Hill North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Safia S.","family":"Kuriakose","sequence":"additional","affiliation":[{"name":"Clinical Research Directorate\/Clinical Monitoring Research Program Leidos Biomedical Research, Inc. Frederick Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jomy M.","family":"George","sequence":"additional","affiliation":[{"name":"Clinical Pharmacokinetics Research Unit, Clinical Center Pharmacy Department National Institutes of Health (NIH) Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gayle","family":"Balba","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Georgetown University Hospital Washington DC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bria","family":"Bailey","sequence":"additional","affiliation":[{"name":"Division of Clinical Research National Institute of Allergy and Infectious Diseases (NIAID), NIH Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Anderson","sequence":"additional","affiliation":[{"name":"Division of Intramural Research NIAID, NIH Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. Clifford","family":"Lane","sequence":"additional","affiliation":[{"name":"Division of Clinical Research National Institute of Allergy and Infectious Diseases (NIAID), NIH Bethesda Maryland"},{"name":"Division of Intramural Research NIAID, NIH Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Maldarelli","sequence":"additional","affiliation":[{"name":"Host Virus Interaction Branch National Cancer Institute, NIH Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice K.","family":"Pau","sequence":"additional","affiliation":[{"name":"Division of Clinical Research National Institute of Allergy and Infectious Diseases (NIAID), NIH Bethesda Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,7,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/00970002042006005"},{"key":"e_1_2_8_3_1","first-page":"75","article-title":"Influence of physicochemical properties on dissolution of drugs in the gastrointestinal tract","volume":"1","author":"Horter D","year":"2001","journal-title":"Adv Drug Deliv Rev"},{"key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1111\/j.1440-1681.2007.04691.x","article-title":"Expression of CYP3A isoforms and P\u2010glycoprotein in human stomach, jejunum and ileum","volume":"11","author":"Canaparo R","year":"2007","journal-title":"Clin Exp Pharmacol Physiol"},{"key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.clpt.2003.10.008","article-title":"Cytochrome P450 3A4 and P\u2010glycoprotein expression in human small intestinal enterocytes and hepatocytes: a comparative analysis in paired tissue specimens","volume":"3","author":"Richter O","year":"2004","journal-title":"Clin Pharmacol Ther"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1086\/503914"},{"key":"e_1_2_8_7_1","first-page":"3307","article-title":"Influence of nevirapine administration on the pharmacokinetics of dolutegravir in patients infected with HIV\u20101","volume":"12","author":"Dailly E","year":"2015","journal-title":"J Antimicrob Chemother"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.10.2733-2739.2001"},{"key":"e_1_2_8_9_1","unstructured":"Gilead Sciences Inc.Emtriva package insert.Foster City CA;2012."},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp130597"},{"key":"e_1_2_8_11_1","unstructured":"Dolutegravir (Tivicay) Clinical Pharmacology Review 2017. Available fromhttp:\/\/www.fda.gov\/downloads\/Drugs\/DevelopmentApprovalProcess\/DevelopmentResources\/UCM370760.pdf. Accessed January 3 2017."},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkr139"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-102-5-619"},{"key":"e_1_2_8_14_1","unstructured":"Tenofovir disoproxil fumarate\/emtricitabine (Truvada) Clinical Pharmacology and Biopharmaceutics Review 2017. Available fromhttp:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/nda\/2004\/021752s000_Truvada_BioPharmr.pdf. Accessed February 17 2017."},{"key":"e_1_2_8_15_1","unstructured":"Gilead Sciences Inc.Viread package insert.Foster City CA;2016."},{"key":"e_1_2_8_16_1","unstructured":"Roskam\u2010KwintM BollenP ColbersA et al.Crushing of dolutegravir combination tablets increases dolutegravir exposure. Poster session presented at: Conference on Retroviruses and Opportunistic Infections (CROI) 2017; 2017 February 13\u201316;Seattle WA."},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325957417692678"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/PHAR.1015"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-014-0666-5"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02278-15"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230X-10-72"},{"key":"e_1_2_8_22_1","unstructured":"SongI ChenS PiscitelliS MinS.Pharmacokinetics (PK) and PK\u2010pharmacodynamic (PD) relationship of dolutegravir (DTG) in integrase inhibitor (INI)\u2013naive subjects [abstract A\u20101573]. 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