Higher plasma drug levels in elderly people living with HIV treated with darunavir
Journal article, 2021

Background The proportion of elderly people living with HIV-1 (PLHIV) is rising. In older patients, comorbidities and concomitant medications are more frequent, increasing the risk of potential drug-drug interactions (PDDIs). Data on the pharmacokinetics of ART in individuals aged < 65 years of age are scarce. We compared plasma drug levels of ART, PDDIs, and sideeffects in PLHIV aged < 65 years of age, with controls > 49 years of age. Methods Patients < 65 years of age and controls > 49 years of age, all of whom were on stable treatment with atazanavir (ATV), darunavir (DRV), or efavirenz (EFV) were included cross-sectionally. Plasma drug levels of ART were analyzed, comorbidities, concomitant medication, adherence, and side-effects recorded, and PDDIs analyzed using drug interactions databases. Results Between 2013 and 2015, we included 100 individuals ≥ 65 years of age (study group) and 99 controls (<49 years of age). Steady-state DRV concentrations were significantly higher in the study group than in the control group (p = 0.047). In the ATV group there was a trend towards a significant difference (p = 0.056). No significant differences were found in the EFV arm. The DRV arm had a higher frequency of reported side-effects than the ATV and EFV arms in the study group (36.7% vs. 0% and 23.8% respectively (p = 0.014), with significant differences between DRV vs. ATV, and EFV vs. ATV). Conclusions Higher steady-state plasma levels of DRV and ATV (but not EFV) were found in PLHIV aged < 65 years of age, compared to controls >49 years of age.


Erika Tyrberg

University of Gothenburg

Sahlgrenska University Hospital

Arvid Edén

Sahlgrenska University Hospital

University of Gothenburg

Jaran Eriksen

Stockholm South General Hospital

Karolinska Institutet

Staffan Nilsson

Chalmers, Mathematical Sciences, Applied Mathematics and Statistics

Carl Johan Treutiger

Stockholm South General Hospital

Anders Thalme

Karolinska University Hospital

Åsa Mellgren

Stockholm South General Hospital

University of Gothenburg

Magnus Gisslen

University of Gothenburg

Sahlgrenska University Hospital

L. M. Andersson

Sahlgrenska University Hospital

University of Gothenburg


1932-6203 (ISSN) 19326203 (eISSN)

Vol. 16 2 February e0246171

Subject Categories


Social and Clinical Pharmacy

Gerontology, specialising in Medical and Health Sciences





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