A retrospective review of the outcomes of 13 HIV-infected transplant patients treated with a raltegravir-containing regimen assessed tolerability, plasma viral load, CD4 cell count, drug interactions, transplant outcome and raltegravir pharmacokinetics. Patients with liver (n=8) or kidney (n=5) transplantation were included. Raltegravir was initiated (400 mg twice daily) either at time of transplantation (n=6), or after transplantation (n=7). There was no evidence of an interaction between raltegravir and the immunosuppressants. Median raltegravir trough concentration was 507 ng/ml (range, 176-890), which is above the in vitro IC95 for wild type HIV-1 strains (15 ng/ml). Target trough levels of tacrolimus or ciclosporin were obtained with standard doses. There were no episodes of acute rejection and HIV infection remained controlled. After a median follow-up of 9 months (range, 6-14), all patients were alive with satisfactory graft function.
Safety and efficacy of raltegravir in HIV-infected transplant patients cotreated with immunosuppressive drugs. Tricot L, Teicher E, Peytavin G, et al. Am J Transplantation, 2009, 9(8): 1946-1952.