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Miltefosine, total amphotericin B and ARV concentrations were determined in dried blood spots or plasma using LC\u2013MS\/MS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Median (IQR) amphotericin B Cmax on Day 1 was 24.6\u2009\u03bcg\/mL (17.0\u201334.9\u2009\u03bcg\/mL), which increased to 40.9 (25.4\u201353.1) and 33.2 (29.0\u201346.6) \u03bcg\/mL on the last day of combination and monotherapy, respectively. Day 28 miltefosine concentration was 18.7 (15.4\u201322.5) \u03bcg\/mL. Miltefosine exposure correlated with amphotericin B accumulation. ARV concentrations were generally stable during antileishmanial treatment, although efavirenz Cmin was below the 1\u2009\u03bcg\/mL therapeutic target for many patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study demonstrates that antileishmanial drug exposure was low in this cohort of HIV co-infected VL patients. Amphotericin B Cmax was 2-fold lower than previously observed in non-VL patients. Miltefosine exposure in HIV-VL co-infected patients was 35% lower compared with adult VL patients in Eastern Africa, only partially explained by a 19% lower dose, possibly warranting a dose adjustment. Adequate drug exposure in these HIV-VL co-infected patients is especially important given the high proportion of relapses.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkab013","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T20:14:52Z","timestamp":1610741692000},"page":"1258-1268","source":"Crossref","is-referenced-by-count":10,"title":["Low antileishmanial drug exposure in HIV-positive visceral leishmaniasis patients on antiretrovirals: an Ethiopian cohort study"],"prefix":"10.1093","volume":"76","author":[{"given":"Anke E","family":"Kip","sequence":"first","affiliation":[{"name":"Department of Pharmacy & Pharmacology, Antoni van Leeuwenhoek Hospital\/Netherlands Cancer Institute, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00e9verine","family":"Blesson","sequence":"additional","affiliation":[{"name":"Drugs for Neglected Diseases Initiative, Geneva, 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