替诺福韦与去羟肌苷联用的严重毒性：病例报告及文献复习

Severe toxicity associated with the combination of tenofovir and didanosine: case report and review.

作者信息

Masiá M, Gutiérrez F, Padilla S, Ramos J M, Pascual J

机构信息

Infectious Diseases Unit, Hospital General Universitario de Elche, Camí de l'Almazara 11, 03203 Elche, Alicante, Spain.

出版信息

Int J STD AIDS. 2005 Sep;16(9):646-8. doi: 10.1258/0956462054944480.

DOI:10.1258/0956462054944480

PMID:16176639

Abstract

The combination of tenofovir and didanosine results in an increase in the didanosine plasma exposure and might augment the risk for didanosine toxicity. Although pharmacokinetic studies support a didanosine dose reduction to 250 mg when used concurrently with tenofovir in patients weighing at least 60 kg, no data are available in lower-weight patients. We describe a case of lactic acidosis and acute liver failure in a low-weight patient receiving tenofovir and a reduced dose of didanosine (200 mg/day). To our knowledge, this is the first case of severe toxicity associated with a reduced dose schedule of didanosine. Previous cases of severe toxicity associated with the combination of tenofovir and didanosine are reviewed.

摘要

替诺福韦与去羟肌苷联合使用会导致去羟肌苷的血浆暴露量增加，并可能增加去羟肌苷毒性风险。尽管药代动力学研究支持体重至少60公斤的患者在与替诺福韦同时使用时将去羟肌苷剂量减至250毫克，但体重较轻的患者尚无相关数据。我们描述了1例接受替诺福韦和减量去羟肌苷（200毫克/天）治疗的低体重患者发生乳酸酸中毒和急性肝衰竭的病例。据我们所知，这是首例与去羟肌苷减量方案相关的严重毒性病例。本文还对先前与替诺福韦和去羟肌苷联合使用相关的严重毒性病例进行了综述。