{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:16:17Z","timestamp":1777418177965,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2009,4,28]],"date-time":"2009-04-28T00:00:00Z","timestamp":1240876800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2009,5]]},"abstract":"\n Background<\/jats:title>\n Itraconazole is the preferred drug for chronic maintenance therapy in HIV-infected patients with disseminated histoplasmosis. Unfortunately, few clinical data exist confirming a presumed interaction between itraconazole and nonnucleoside reverse transcriptase inhibitors (NNRTIs).<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine whether serum itraconazole concentrations are affected by the type of antiretroviral therapy (NNRTI or protease inhibitor [PI]) being taken concomitantly.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective cohort identified patients on antiretroviral therapy and itraconazole for disseminated histoplasmosis between January 2003 and December 2006 at a large HIV clinic in Houston, TX. Available laboratory values were abstracted from medical records.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Thirteen itraconazole concentrations from 10 patients were avaitable for analysis: 7 patients were on concomitant Pls, 4 on concomitant NNRTIs, and 2 on antiretroviral regimens containing both Pls and NNRTIs. Six of the itraconazole concentrations during concomitant PI treatment were therapeutic (>1.0 \u03bcg\/mL). in contrast with none in patients taking an NNRTI. All patients taking concomitant NNRTIs had undetectable serum itraconazole concentrations (<0.05 \u03bcg\/mL). Two patients switched from NNRTI-based to PI-based antiretroviral regimens and subsequently reached therapeutic itraconazole concentrations. Although limited by small sample size, this study provides the largest clinical data among HIV-infected patients demonstrating that coadministration of an NNRTI and itraconazole results in significant decreases in itraconazole blood concentrations, likely by inducing the CYP3A4 enzyme system.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Itraconazole concentrations should be monitored in patients taking concomitant NNRTIs. PI-based highly active antiretroviral therapy (HAART) may be preferred over NNRTI-based HAART when itraconazole is used to treat HIV-infected patients with disseminated histoplasmosis.<\/jats:p>\n <\/jats:sec>","DOI":"10.1345\/aph.1l624","type":"journal-article","created":{"date-parts":[[2009,5,5]],"date-time":"2009-05-05T12:32:55Z","timestamp":1241526775000},"page":"908-913","source":"Crossref","is-referenced-by-count":12,"title":["Clinical Evidence of Interaction Between Itraconazole and Nonnucleoside Reverse Transcriptase Inhibitors in HIV-Infected Patients with Disseminated Histoplasmosis"],"prefix":"10.1177","volume":"43","author":[{"given":"Roberto A","family":"Andrade","sequence":"first","affiliation":[{"name":"Section of Infectious Diseases, Baylor College of Medicine, Houston, TX; Thomas Street Health Center, Harris County Hospital District, Houston"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard T","family":"Evans","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Baylor College of Medicine; Thomas Street Health Center, Harris County Hospital District"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard J","family":"Hamill","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Baylor College of Medicine; Michal E DeBakey Veterans Affairs Medical Center, Houston"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teddy","family":"Zerai","sequence":"additional","affiliation":[{"name":"Thomas Street Health Center, Harris County Hospital District"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas P","family":"Giordano","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Baylor College of Medicine; Medical Director, Thomas Street Health Center, Harris County Hospital District"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2009,4,28]]},"reference":[{"key":"bibr1-aph.1L624","doi-asserted-by":"publisher","DOI":"10.1086\/513653"},{"key":"bibr2-aph.1L624","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(88)80334-6"},{"key":"bibr3-aph.1L624","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(99)80311-8"},{"key":"bibr4-aph.1L624","doi-asserted-by":"publisher","DOI":"10.1086\/313752"},{"key":"bibr5-aph.1L624","unstructured":"America UPHSaIDSo. Guidelines for preventing opportunistic infections among HIV-infected persons\u20132008. 2008: 1\u2013276. http:\/\/aidsinfo.nih.gov (accessed 2008 Nov 20)."},{"key":"bibr6-aph.1L624","doi-asserted-by":"publisher","DOI":"10.1086\/420749"},{"key":"bibr7-aph.1L624","doi-asserted-by":"publisher","DOI":"10.1517\/17425255.1.3.473"},{"key":"bibr8-aph.1L624","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200161001-00003"},{"key":"bibr9-aph.1L624","unstructured":"Prescribing information. Sporanox (itraconazole). U.S. Ortho-McNeil: Our Products. www.ortho-mcneil.com (accessed 2008 Nov 20)."},{"key":"bibr10-aph.1L624","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-007-0282-8"},{"key":"bibr11-aph.1L624","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-007-0280-x"},{"key":"bibr12-aph.1L624","author":"Kaul S","year":"2007","journal-title":"Presented at: 14th Conference on Retrovirus and Opportunistic Infections (CROI)"},{"key":"bibr13-aph.1L624","unstructured":"DHHS panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents, Nov 3, 2008: 26\u20137. http:\/\/aidsinfo.nih.gov (accessed 2008 Nov 20)."},{"key":"bibr14-aph.1L624","doi-asserted-by":"publisher","DOI":"10.1086\/382675"},{"key":"bibr15-aph.1L624","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/43.5.723"},{"key":"bibr16-aph.1L624","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-118-8-199304150-00006"},{"key":"bibr17-aph.1L624","author":"Taylor S","year":"2004","journal-title":"Presented at: 11th Conference on Retrovirus and Opportunistic Infections"},{"key":"bibr18-aph.1L624","doi-asserted-by":"publisher","DOI":"10.1086\/520978"},{"key":"bibr19-aph.1L624","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3283097d0f"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1L624","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1L624","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:06:31Z","timestamp":1777374391000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1345\/aph.1L624"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,4,28]]},"references-count":19,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2009,5]]}},"alternative-id":["10.1345\/aph.1L624"],"URL":"https:\/\/doi.org\/10.1345\/aph.1l624","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,4,28]]}}}