Cervino Ahern Leigh, Nixon Daniel, Fulco Patricia Pecora
The Johns Hopkins Hospital, Department of Pharmacy, Baltimore, MD, USA.
Virginia Commonwealth University Health, Department of Internal Medicine/Division of Infectious Diseases, Richmond, VA, USA.
IDCases. 2024 Jun 25;37:e02017. doi: 10.1016/j.idcr.2024.e02017. eCollection 2024.
Antiretroviral (ARV) absorption in persons living with human immunodeficiency virus (PLWH, HIV) with short bowel syndrome is limited. We describe a case of a 28-year-old male with newly diagnosed HIV and plasmablastic lymphoma with proximal jejunostomy necessitating parenteral nutrition. ARV therapy with dolutegravir 50 mg twice daily and once daily tenofovir/emtricitabine was initiated with documented malabsorption and delayed virologic suppression (VS). Dolutegravir dose titration with therapeutic drug monitoring (TDM) resulted in VS at month 12. ARV TDM with dose titration is an option for PLWH with malabsorptive states to maintain VS.
人类免疫缺陷病毒（HIV）感染者合并短肠综合征时，抗逆转录病毒（ARV）药物的吸收受限。我们报告一例28岁男性，新诊断为HIV感染并患有浆母细胞淋巴瘤，因近端空肠造口术需要肠外营养。开始使用多替拉韦50mg每日两次及替诺福韦/恩曲他滨每日一次进行抗逆转录病毒治疗，记录显示存在吸收不良和病毒学抑制（VS）延迟。通过治疗药物监测（TDM）进行多替拉韦剂量滴定，在第12个月时实现了病毒学抑制。对于存在吸收不良状态的HIV感染者，通过剂量滴定进行抗逆转录病毒治疗药物监测是维持病毒学抑制的一种选择。
