{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:42:06Z","timestamp":1777419726544,"version":"3.51.4"},"reference-count":14,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2009,11,25]],"date-time":"2009-11-25T00:00:00Z","timestamp":1259107200000},"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":[[2009,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To report the results of therapeutic drug monitoring of lopinavir\/ritonavir and itraconazole concentrations in an HIV-infected male who was treated for histoplasmosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Summary:<\/jats:title>\n                    <jats:p>\n                      A 34-year-old HIV-infected man who had recently initiated efavirenz-based antiretroviral therapy was diagnosed with disseminated Histoplasma capsulatum infection. In the hospital, lopinavir\/ritonavir 400 mg\/100 mg twice daily replaced efavirenz to avoid etavirenz-itraconazole interactions. After 14 days of liposomal amphotericin B therapy, itraconazole solution was initiated at 150 mg twice daily for 3 days, followed by 200 mg daily. Prior to itraconazole initiation, lopinavir trough concentration was 7.4 mg\/L. The lopinavir trough concentration 15 days later, after 14 days of itraconazole, was 6.8 mg\/L. An itraconazole concentration measured 2 hours post-dose on day 15 of oral therapy was 1.9 pg\/mL. After 2 weeks of liposomal amphotericin, urine Histoplasma antigen was 27.23 ng\/mL; after 5 months of oral itraconazole therapy, it decreased to 5.24 ng\/mL. Plasma HIV RNA decreased 4.26 log\n                      <jats:sub>10<\/jats:sub>\n                      in 5 months to less than 40 copies\/mL The patient has demonstrated marked clinical improvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>In this case, dosing recommendations of itraconazole 200 mg daily with lopinavir\/ritonavir were appropriate. Lopinavir trough concentrations were not significantly different following the addition of itraconazole and were above the minimum target of 1 mg\/L in treatment-naive patients. The itraconazole concentration was above the recommended concentration of at least 1 \u03bcg\/mL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The dose of itraconazole was reduced to 200 mg daily as recommended by current guidelines, and therapeutic drug monitoring of both itraconazole and lopinavir concentrations confirmed that no further dosage adjustments were necessary.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1m393","type":"journal-article","created":{"date-parts":[[2009,11,24]],"date-time":"2009-11-24T23:58:13Z","timestamp":1259107093000},"page":"2117-2120","source":"Crossref","is-referenced-by-count":7,"title":["Drug-Drug Interaction Between Itraconazole and the Protease Inhibitor Lopinavir\/Ritonavir"],"prefix":"10.1177","volume":"43","author":[{"given":"Cara","family":"Hills-Nieminen","sequence":"first","affiliation":[{"name":"Northern Alberta HIV Program and Regional Pharmacy Services, Alberta Health Services, Edmonton, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine A","family":"Hughes","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton; Clinical Pharmacotherapy Practitioner\u2013HIV, Northern Alberta HIV Program and Regional Pharmacy Services, Alberta Health Services"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stan","family":"Houston","sequence":"additional","affiliation":[{"name":"Northern Alberta HIV Program; Professor of Medicine and Public Health, Division of Infectious Diseases, Department of Medicine, University of Alberta"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen D","family":"Shafran","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Alberta"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2009,11,25]]},"reference":[{"key":"bibr1-aph.1M393","unstructured":"Centers for Disease Control and Prevention. Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents. Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. MMWR Early Release 2009;58(March 24):1\u2013207."},{"key":"bibr2-aph.1M393","first-page":"121","volume":"26","author":"Becker SJ","year":"2009","journal-title":"Infect Med"},{"key":"bibr3-aph.1M393","doi-asserted-by":"publisher","DOI":"10.1086\/521259"},{"key":"bibr4-aph.1M393","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200161001-00003"},{"key":"bibr5-aph.1M393","unstructured":"Itraconazole. DRUGDEX System. Greenwood Village, CO: Thomson Micromedex. www.thomsonhc.com (accessed 2008 Oct 30)."},{"key":"bibr6-aph.1M393","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.8.17.2947"},{"key":"bibr7-aph.1M393","unstructured":"Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. Department of Health and Human Services. November 3, 2008. www.aidsinfo.nih.gov.ContentFiles\/AdultandAdolescentGL.pdf (accessed 2008 Nov 6)."},{"key":"bibr8-aph.1M393","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2006.74.600"},{"key":"bibr9-aph.1M393","doi-asserted-by":"publisher","DOI":"10.1086\/520978"},{"key":"bibr10-aph.1M393","doi-asserted-by":"publisher","DOI":"10.1086\/382675"},{"key":"bibr11-aph.1M393","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1L624"},{"key":"bibr12-aph.1M393","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0b013e3282f82c1b"},{"key":"bibr13-aph.1M393","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00705-08"},{"key":"bibr14-aph.1M393","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.35.4.707"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1M393","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1M393","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:11:18Z","timestamp":1777374678000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1345\/aph.1M393"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,11,25]]},"references-count":14,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2009,12]]}},"alternative-id":["10.1345\/aph.1M393"],"URL":"https:\/\/doi.org\/10.1345\/aph.1m393","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,11,25]]}}}